Study on the application of clinical pathway in patients with acute ST elevated myocardial infarction

Objective:To evaluate the practicability of application of clinical pathway in patients with acute ST-elevation myocardial infarction(STEMI).Methods:Sixty-one cases of STEMI within 12 h of symptom onset were received primary percutaneous coronary intervention.All patients were randomly divided into two groups, 35 cases were brought directly to catheterization laboratory(rapid group), and 26 cases were admitted to the coronary care unit or cardiac ward firstly, then transferred to the catheterization laboratory(slow group).Hospitalization expenses, hospitalization time, the psychological changes of the subjects, patients' satisfaction degree were recorded.The psychological changes of the subjects were determined by self-rating anxiety scale(SAS) and self-rating depression scale(SDS).Results:In rapid group, the total hospitalization expenses, the western medicine expenses, and the hospitalization time were significantly shorter than in slow group(P<0.01);but the hospitalization expenses per day was higher than in slow group (P<0.01).SAS and SDS indices were decreased significantly in rapid group compared with those in slow group(P<0.01 and P<0.05).Patients were more satisfied with their treatments in rapid group (P<0.01).Conclusions:Application of clinical pathway in the STEMI patients can obviously decrease expenses, hospitalization time and psychological problems.And it can increase the satisfaction degree of patients.It is a new and effective management mode.