Clinical Performance and Quality Measures for Adults With Acute ST-Elevation Myocardial Infarction in China

Condition(s) studied

Investigational drug(s) / intervention(s)

Quality improvement strategies and tools: Quality improvement strategies and tools

Study summary

This study aims to investigate and evaluate clinical performance and quality measures for adults with acute ST-elevation myocardial infarction (STEMI) in China. Further more, the investigates like to develop quality improvement strategies and relevant tools focusing on treatment and clinical outcome in patients with STEMI. This is a annually survey , through consecutively recruiting all eligible inpatients and collecting relevant medical information, the performance of all participating hospitals. Further, quality improvement strategies including summary of clinical performance and quality measures, clinical pathways and team building will be organized for the purpose of quality improvement. All hospitals will consecutively recruit qualified patients in the same method adopted in baseline period. Then the reperfusion rates and other performance measures will be compared annually.

Eligibility

Primary outcome measure(s)

• Aspirin at arrival — 24 hours after admission
  Proportion of aspirin use within 24 hours of admission among eligible patients
• Clopidogrel (or ticagrelor) at arrival — 24 hours after admission
  Proportion of Clopidogrel (or ticagrelor) use within 24 hours of admission among eligible patients
• β-blockers at arrival — 24 hours after admission
  Proportion of β-blockers use within 24 hours of admission among eligible patients
• ECG at arrival — 24 hours after admission
  Proportion of ECG test within 10 minutes of admission among eligible patients
• Reperfusion therapy rate — 24 hours after admission
  Reperfusion therapy rate is defined as utilization rate of thrombolytic therapy or primary PCI treatment among patients indicated with the reperfusion therapy.
• Time delay from failure of fibrinolysis to angiography(The time from start of fibrinolysis to evaluation of its efficacy is 60-90min) — 10 days on average (during hospitalization)
  The proportion of failure of fibrinolysis to balloon within 90 minutes among all patients receiving PCI.
• Time delay from start of fibrinolysis to angiography(if fibrinolysis is successful) — 10 days on average (during hospitalization)
  The proportion of from fibrinolysis to balloon (if fibrinolysis is successful) within 2-24hours among all patients receiving PCI.
• Timeliness of thrombolytic therapy — 24 hours after admission
  The proportion of door to needle time (D2N) within 30 minutes among all patients receiving fibrinolytic therapy.
• Timeliness of primary PCI — 24 hours after admission
  The proportion of door to balloon (D2B) within 90 minutes among all patients receiving primary PCI.
• Door-in-Door-Out Time — 24 hours after admission
  Percentage of patients whose median time from the emergency department arrival at STEMI referral facility to emergency department discharge from STEMI referral facility is equal or less than 30 min. discharge from STEMI referral facility is 30 min.
• Time to Primary PCI Among Transferred Patients — 24 hours after admission
  Percentage of patients whose median time from first medical contact (at or before emergency department arrival to the STEMI referral facility \[e.g., non-PCI-capable facility\]) to primary PCI at the STEMI receiving facility (PCI-capable facility) is equal or less than 120 min
• Evaluation of LDL-C — 10 days on average (during hospitalization)
  Percentage of patients with documentation in the hospital record that LDL-C is evaluated during hospitalization
• Evaluation of left ventricular ejection fraction — 10 days on average (during hospitalization)
  Percentage of patients with documentation in the hospital record that left ventricular ejection fraction is evaluated during hospitalization
• Aspirin use during hospitalization — 10 days on average (during hospitalization)
  Proportion of Aspirin use during hospitalization among eligible patients.
• Clopidogrel (or ticagrelor) use during hospitalization — 10 days on average (during hospitalization)
  Proportion of Clopidogrel (or ticagrelor) use during hospitalization among eligible patients.
• β-blockers use during hospitalization — 10 days on average (during hospitalization)
  Proportion of β-blockers use during hospitalization among eligible patients.
• Angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use during hospitalization — 10 days on average (during hospitalization)
  Proportion of Angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use during hospitalization among eligible patients.
• Statins use during hospitalization — 10 days on average (during hospitalization)
  Proportion of statins use during hospitalization among eligible patients.
• Aspirin use at discharge — 10 days on average (during hospitalization)
  Proportion of aspirin use at discharge among eligible patients.
• Clopidogrel (or ticagrelor) use at discharge — 10 days on average (during hospitalization)
  Proportion of Clopidogrel (or ticagrelor) use at discharge among eligible patients.
• β-blockers use at discharge — 10 days on average (during hospitalization)
  Proportion of β-blockers use at discharge among eligible patients.
• angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use at discharge — 10 days on average (during hospitalization)
  Proportion of angiotensin-converting enzyme inhibitor /angiotensin II receptor blocker use at discharge among eligible patients.
• Statins use at discharge — 10 days on average (during hospitalization)
  Proportion of statins use at discharge among eligible patients.
• Aldosterone Antagonist at Discharge — 10 days on average (during hospitalization)
  Proportion of Aldosterone Antagonist use at discharge among eligible patients.
• Smoking cessation advice/ counseling at Discharge — 10 days on average (during hospitalization)
  Proportion of patients received smoking cessation advice/ counseling
• all-cause mortality during hospitalization — 10 days on average (during hospitalization)
  Proportion of patients who were all-cause death during hospitalization
• Cardiac mortality during hospitalization — 10 days on average (during hospitalization)
  Proportion of patients who were cardiac death during hospitalization
• 30-day all-cause mortality — From admission to 30days
  Proportion of patients who were all-cause death from admission to 30days
• 30-day cardiac mortality — From admission to 30days
  Proportion of patients who were cardiac death from admission to 30days
• 30-day readmission rates — From hospital discharge to 30 days
  Proportion of patients readmission from hospital discharge to 30days
• Cost during hospitalization — 10 days on average (during hospitalization)
  Cost during hospitalization

Trial sites (1)

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