Current situation of emergency medical service system for patients with acute myocardial infarction in Hebei Province and its influence on treatment and prognosis
10.3760/cma.j.issn.1671-0282.2021.07.003
- VernacularTitle:河北省急性心肌梗死患者使用急诊医疗服务系统现状分析及对治疗和预后影响
- Author:
Yutong LI
1
;
Hengbo GAO
;
Dongqi YAO
;
Hao XIAO
;
Yanling DONG
;
Baopu LYU
;
Liang LIU
;
Hui CHEN
;
Yiqing SUN
;
Yingping TIAN
Author Information
1. 河北医科大学第二医院急诊科，石家庄 050000
- Keywords:
Acute myocardial infarction;
Emergency medical service system;
Admission way;
Reperfusion therapy;
Fatality rate
- From:
Chinese Journal of Emergency Medicine
2021;30(7):809-815
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the current situation of emergency medical service (EMS) system and its effect on treatment of the acute stage and short- and long-term prognosis in patients with acute myocardial infarction in Hebei province.Methods:Totally 2 961 patients with acute myocardial infarction who were admitted to major tertiary and some representative secondary hospitals in Hebei province from January 2016 to December 2016 were collected. According to the pattern of arriving hospital, all the patients were divided into the EMS group and self-transport group. The general conditions, time from onset to treatment, treatment methods, in-hospital mortality rate and 3-year mortality rate were compared between the two groups.Results:Of the included 2 961 patients, 33.13% of them were transported through EMS and 66.87% of them by private transport. Patients with a history of hypertension and ST-segment elevation myocardial infarction were more likely to choose EMS, and the difference was statistically significant ( P<0.05). Moreover, patients in the EMS group were more likely to go to tertiary hospitals for treatment (88.58% vs 85.76%, P=0.033). The time from onset to treatment of the EMS group was significantly shorter than that of the self-transport group (160 min vs 185 min, P<0.01), and the proportion of patients in the EMS group from onset-to-door time in <3 h and 3-6 h was higher than that of the self-transport group (55.76% vs 49.14%, 21.41% vs 19.09%, P<0.01). Compared with the self-transport group, the EMS group has a higher rate of reperfusion therapy (67.48% vs 61.67%, P=0.002). Patients in the EMS group had a higher in-hospital mortality rate in the acute stage (7.03% vs 4.44%, P=0.003), but its 3-year mortality rate was lower than that of the self-transport group (17.31% vs 20.77%, P<0.05). Conclusions:EMS can shorten symptom-onset-to-arrival time, increase the rate of reperfusion therapy and improve long-term prognosis of patients with acute myocardial infarction.
