Stent for Life Italia: Da Nord a Sud
description
Transcript of Stent for Life Italia: Da Nord a Sud
![Page 1: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/1.jpg)
Stent for Life Italia: Da Nord a Sud
Incontro SFL con le aziende
Milano, Rosa Grand Starhotels04 Aprile 2012
Leonardo De Luca, M.D., Ph.D., F.A.C.C.
Department of Cardiovascular SciencesInterventional Cardiology UnitEuropean HospitalRome, [email protected]
![Page 2: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/2.jpg)
Phase Transition
![Page 3: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/3.jpg)
Phase Transition
![Page 4: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/4.jpg)
Stent for Life InitiativeITALIA
Total of Inhabitants included in SFL ITALIA program (2012) :
21.000.000 inhabitants,35% of the total population
![Page 5: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/5.jpg)
4.090.877 inhabitants6 Districts258 municipal districtsArea: 19.358 km2
17 Cath Labs1687 Primary PCI
Puglia
![Page 6: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/6.jpg)
Puglia
100% ambulances with ECG teletrasmission (n=169) From Oct 2004 to Dec 2010
Total ECG IMA MalignantArrhythmias
![Page 7: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/7.jpg)
Puglia
![Page 8: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/8.jpg)
587.517 inhabitants2 Districts131 municipal districtsArea: 9.992 km2
1 Cath Lab61 Primary PCI
Basilicata
31 ambulances; 17.000 calls/yr (50% chest pain)ECG Teletransmission; Telesal Project
New regional project on STEMI network (02/11)Pre-H Thrombolysis
![Page 9: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/9.jpg)
SABATO 5 MAGGIO 2012
Stent for life per TUTTI i LUCANI Moderatori: A. Leccese; L. Truncellito
11:00 Stent for Life (R Osanna)11:15 Un anno di RETE-STEMI in Basilicata: come superare le criticità? (G. Calculli)11:30 Tavola Rotonda: A. Martorano (Assessore Salute e Sicurezza); M. Marra (Direttore Generale ASP); G. Maruggi (Direttore Generale ASM); Direttore Generale Azienda O. San Carlo di Potenza; L. Mileti (Dip. Emergenza/Urgenza Potenza); R. Di Leo (PSA Policoro)
Basilicata
![Page 10: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/10.jpg)
4.937.854 inhabitants7 Districts581 municipal districtsArea: 18.391 km2
21 Cath Labs2022 Primary PCI
Veneto
Bur n. 15 del 19/02/2008
![Page 11: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/11.jpg)
0100200300400500600700
www.gise.it
Primary PCI/1.000.000 inhabitantsIn Italy
-
-
+150
-50
N
%
0
![Page 12: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/12.jpg)
DGR 4550 del 28.12.2007Rete integrata interospedaliera per il trattamento in emergenza dell’infarto miocardico acuto (IMA) nella Regione Veneto
Novità nel Protocollo pPCI:
- Tipo di riperfusione (in base a tempo di insorgenza sintomi, tempi di trasferimento, età, rischio emorragico, controindicazioni Fx)
- Protocollo farmacologico (Prasugrel, Bivalirudina)
![Page 13: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/13.jpg)
PCI primarie/rescue anni 2005-2010
0
500
1000
1500
2000
2500
2005 2006 2007 2008 2009 2010
primarierescue
Fonte: dati GISE
287/106/ANNO
410/106/ANNO
![Page 14: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/14.jpg)
PCI primarie/STEMI (SDO) 2005-2010
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
2005 2006 2007 2008 2009 2010
Fonte: dati GISE + Regione Veneto
29%32%
37% 42%48%
55%
STEMI (SDO) PRIMARIE
52%
VENERE (2003)
![Page 15: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/15.jpg)
Differenze geografiche nel tasso di pPCI
Fonte: dati GISE + Regione Veneto
0
100
200
300
400
500
600
700
VERONA PADOVA VICENZA TV-BL VENEZIA ROVIGO
pPCI/106/anno
410
Media Regionale
600
Target GISE-EAPCI
330 349 368 386 539 684
![Page 16: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/16.jpg)
4.457.335 inhabitants8 Districts1.206 municipal districtsArea: 25.399 km2
25 Cath Labs2129 Primary PCI
Piemonte
![Page 17: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/17.jpg)
Clinical Server
MobiMed 300 Comunicazione
Wireless hub spoke
GSM
Linee Rupar
72 ambulances+5 helicoptersClient Use in 30 CCUs
Piemonte
![Page 18: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/18.jpg)
RETE INTEROSPEDALIERA EMERGENZA CORONARICA
Rilevazione maggio-giugno 2011:I percorsi di assistenza e di cura della
RETE STEMI
Torino, 27 gennaio 2012
RETE INTEROSPEDALIERA EMERGENZA CORONARICA
Dalla Programmazione di un Percorso alla sua Realizzazione Pratica: la Rete STEMI della Regione Piemonte
![Page 19: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/19.jpg)
sede(torino)chivasso
ciriegiovannibosco
ivreamariavittoria
martinimauriziano
molinetteospmolinetteuni
moncalieripinerolo
rivolisanluigi
sedebiella
borgomaneroborgosesia
domodossola
novaraverbaniavercelli
sedeacquiterme
alessandriaasti
casalenoviligure
tortona
sedealba
cuneomondovisavigliano
RISULTATI – EVENTI entro 12h osservati e confronto con eventi attesi dallo Studio PRIMA
osservati171
osservati:68
osservati:75
osservati:52
attesi:206
attesi:91
attesi:57
attesi:55
=
![Page 20: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/20.jpg)
tutte le provenienze
gbosco
rivoli
cirie
mvittoria
vercelli
novara
alessandria
cuneo
chivasso
ivrea
martini
pinerolo
borgomanero
acquiterme
verbania
noviligure
mondovi
= spoke
= hub
sanluigi
domodossola
avigliana
= nohub/nospoke
molin.osp molin.unimauriziano
moncalieri
biella
asti
savigliano
alba
casale
borgosesia
tortona
ovada
valenza
bra
carmagnola
chieri
cuorgne
gradenigo
giaveno
lanzo
nizza
saluzzo
susa
ceva
omegna
2
3
2
1
3
1
1
4
5
4 5
1
1
2
2 2
4 12
4
41
4
1
3
3
4
1
3
1
1
3
1
4
![Page 21: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/21.jpg)
5.834.056 inhabitants5 Districts551 municipal districtsArea: 13.595 km2
19 Cath Labs1760 Primary PCI
Campania
![Page 22: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/22.jpg)
NEEDS FOR AMI NET
NUMBER OF CCU ADEQUATE BUT NOT WELL DISTRIBUITED ON THE
TERRITORY
NUMBER OF CATH LABS ADEQUATE BUT NOT WELL DISTRIBUITED ON
THE TERRITORY AND NOT AVAILABLE 24H A DAY.
AMBULANCES ON THE TERRITORY (118) NUMERICALLY INADEQUATE
AND NOT CONNECTED EACH OTHER AND WITH THE CCU.
PART OF THE TERRITORY COMPLETELY WITHOUT ANY CARDIOLOGIC
EMERGENCY ASSISTANCE.
![Page 23: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/23.jpg)
![Page 24: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/24.jpg)
![Page 25: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/25.jpg)
![Page 26: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/26.jpg)
•Modello organizzativo della rete e definizione dei bacini di utenza e delle Unità di rete (DECRETO Commissariale N° 49 del 27/9/2010)
•Censimento dell’organizzazione del Servizio di Emergenza territoriale del 118 per l’esatta definizione della mappa regionale.
•Definizione dell’organigramma ed i compiti degli organismi regolatori della rete:
•Commissione regionale di coordinamento, Comitati Tecnici provinciali o Macro Aree;
•Definizione dei Compiti della Commissione Regionale e dei Comitati Tecnici.
•Organizzazione dei corsi formazione personale Medico e Paramedico 118 (Individuata Task Force formazione)
•Definizione delle Strategie Terapeutiche delineate nei documenti delle Linee Guida elaborate dalla Società Europea di Cardiologia.
•Definizione degli indicatori di efficienza di rete.
•Start-up rete Provincia pilota.
•Campagne educazionali per i cittadini e i Medici di Medicina Generale.
![Page 27: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/27.jpg)
Campania
![Page 28: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/28.jpg)
5.051.075 inhabitants9 Districts390 municipal districtsArea: 25.708 kmq 19 Cath Labs2415 Primary PCI
Sicilia
![Page 29: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/29.jpg)
Stent for Life InitiativeITALIA
![Page 30: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/30.jpg)
Sicilia
![Page 31: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/31.jpg)
Sicilia
![Page 32: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/32.jpg)
2.010.709 inhabitants5 Districts409 municipal districtsArea: 15,080 kmq 7 Cath Labs589 Primary PCI
Calabria
![Page 33: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/33.jpg)
Calabria
![Page 34: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/34.jpg)
Calabria
![Page 35: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/35.jpg)
Calabria
![Page 36: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/36.jpg)
Stent for Lifee le Metamorfosi di Ovidio
![Page 37: Stent for Life Italia: Da Nord a Sud](https://reader035.fdocuments.us/reader035/viewer/2022062409/56814f3c550346895dbce10f/html5/thumbnails/37.jpg)
Stent for Lifee le Metamorfosi di Ovidio