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Prehospital tele-electrocardiographic triage improves the management of acute coronary syndrome in rural populations: A systematic review and meta-analysis.
- Source :
-
Journal of Telemedicine & Telecare . Oct2022, Vol. 28 Issue 9, p632-641. 10p. - Publication Year :
- 2022
-
Abstract
- <bold>Introduction: </bold>Acute coronary syndrome (ACS) patients residing in rural areas are predisposed to higher risk of poor outcomes due to substantial delays in disease management, emphasising the importance of emerging telecardiology technologies in delivering emergency services in such settings. This meta-analysis aimed to investigate the impacts of prehospital telecardiology strategies on the clinical outcomes of rural ACS patients.<bold>Methods: </bold>A literature search was performed of articles published up to April 2020 through six databases. Included studies were assessed for bias risk using the ROBINS-I tool, and a random-effects model was utilised to estimate effect sizes. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).<bold>Results: </bold>Twelve studies with a total of 3989 patients were included in this review. Prehospital telecardiology in the form of tele-electrocardiography (tele-ECG) enabled prompt diagnosis and triage, resulting in a decreased door-to-balloon (DTB) time (mean difference = -25.53 minutes, 95% confidence interval (CI) -36.08 to -14.97 minutes; I2 = 98%), as well as lower in-hospital mortality (odds ratio (OR) = 0.57, 95% CI 0.36-0.92) and long-term mortality (OR = 0.52, 95% CI 0.39-0.69) rates, both with negligible heterogeneity (I2 = 0%). GRADE assessment yielded very low to moderate certainty of evidence.Conclusion Prehospital tele-ECG appeared to be an effective and worthwhile approach in the management of rural ACS patients, as shown by moderate quality evidence on lower long-term mortality. Given the uncertainties of the evidence quality on DTB time and in-hospital mortality, future studies with a higher quality of evidence are required to confirm our findings. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ACUTE coronary syndrome
*RURAL population
*HOSPITAL mortality
*TECHNOLOGICAL innovations
*MEDICAL triage
*TREATMENT of acute coronary syndrome
*RESEARCH
*FERRANS & Powers Quality of Life Index
*META-analysis
*RESEARCH methodology
*EVALUATION research
*COMPARATIVE studies
*EMERGENCY medical services
*ELECTROCARDIOGRAPHY
*TELEMEDICINE
Subjects
Details
- Language :
- English
- ISSN :
- 1357633X
- Volume :
- 28
- Issue :
- 9
- Database :
- Academic Search Index
- Journal :
- Journal of Telemedicine & Telecare
- Publication Type :
- Academic Journal
- Accession number :
- 158906972
- Full Text :
- https://doi.org/10.1177/1357633X20960627