Effect of regional synergistic treatment system on the treatment time and short-term prognosis of ST-segment elevation myocardial infarction
10.3760/cma.j.issn.2095-4352.2017.10.003
- VernacularTitle:区域协同救治体系对ST段抬高型心肌梗死救治时间及近期预后的影响
- Author:
Guoxin ZHANG
1
;
Changshun LI
;
Hengtao LI
;
Lijuan GAO
;
Geng LI
;
Xianhui ZHANG
;
Jie GUO
;
Binquan YOU
;
Feng LIU
Author Information
1. 上海交通大学医学院附属苏州九龙医院急诊科
- Keywords:
ST-segment elevation myocardial infarction;
Symptom onset to balloon dilatation;
First medical contact to balloon dilatation;
Door to balloon dilatation;
Regional synergistic treatment system
- From:Chinese Critical Care Medicine
2017;29(10):877-881
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of regional synergistic treatment system on the treatment time and short-term prognosis of patients with ST-segment elevation myocardial infarction (STEMI).Methods A retrospective analysis of the clinical data of STEMI patients who admitted to emergency center of Suzhou Kowloon Hospital Affiliated to Shanghai Jiaotong University School of Medicine and underwent primary percutaneous coronary intervention (PPCI) from January 2013 to January 2017 were conducted. All patients were divided into two groups, group A was the patients who underwent the PPCI before the establishment of the acute chest pain area co-treatment system (from January 2013 to December 2014), and group B was the patients who received the treatment after the establishment of the area co-treatment system (from January 2015 to January 2017). The length of time from onset of symptoms to the balloon dilatation (S2B), the length of time from the first medical contact to the balloon dilatation (FMC2B), the length of time from entering the gate of hospital to the balloon dilatation (D2B), and the incidence of 90-day end point events (including heart failure, all-cause death, and other related adverse events) were collected. The relations of the establishment of the acute chest pain area co-treatment system and the incidence of 90-day end point events were analyzed by multivariable Logistic regression analysis.Results Among the 221 enrolled patients with STEMI, 83 patients were in group A and 138 patients were in group B respectively. Compared with group A, S2B time [minutes: 180 (140, 210) vs. 201 (154, 225)], FMC2B time [minutes: 89 (78, 100) vs. 94 (83, 107)] and D2B time [minutes: 66 (62, 70) vs. 85 (72, 99)] were significantly shortened in group B (allP < 0.05), the incidence of 90-day end point events were significantly decreased (heart failure:20.3％ vs. 32.5％, all-cause death: 1.4％ vs. 7.2％, other related adverse events: 23.2％ vs. 36.1％, allP < 0.05). It was shown by multivariable Logistic regression analysis that the establishment of the acute chest pain area co-treatment system could lower the incidence of 90-day end point events [heart failure: odds ratio (OR) = 1.904, 95％ confidence interval (95％CI) = 0.968-1.004, P = 0.048; all-cause death:OR = 11.724, 95％CI = 0.955-1.048,P = 0.013; other related adverse events:OR = 1.925, 95％CI = 1.049-3.530,P = 0.034].Conclusion The construction of regional synergistic treatment system can shorten the emergency treatment time of STEMI patients and reduce the incidence of 90-day end point events including heart failure and death.
