Impact of first contact hospital on timing of treatment for patients with acute ST-elevation myocardial infarction
10.3760/cma.j.cn114798-20210915-00699
- VernacularTitle:首诊机构对急性ST段抬高型心肌梗死患者救治时效性的影响
- Author:
Huili CHEN
1
;
Meihong QIU
;
Hang LU
;
Guangjie PAN
;
Songsen LI
Author Information
1. 郑州大学附属洛阳中心医院心脏重症监护室，洛阳 471000
- Keywords:
ST-elevation myocardial infarction;
Door-to-balloon time;
Referral delay
- From:
Chinese Journal of General Practitioners
2022;21(2):174-177
- CountryChina
- Language:Chinese
-
Abstract:
Clinical data of 655 patients with acute ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) in Luoyang Central Hospital during January 2017 to March 2020 were analyzed retrospectively. There were 425 cases who first visited PCI-capable hospital (PCI hospital group) and 230 cases who were transferred to PCI-capable hospital (transfer group). Compared with PCI hospital group, STEMI patients in the transfer group had a shorter first diagnosis time [2.0 (0.8, 4.2)h vs. 2.5(1.2, 4.1)h, Z=3.66, P<0.01], longer time from first medical contact to the balloon through (FMC2B) [175 (113, 344) min vs. 75 (57, 112) min, Z=-8.92, P<0.01], longer total ischemic time [5.4 (3.5, 9.8) h vs. 3.9 (2.4, 6.0) h, Z=-5.43, P<0.01]. There was no significant difference in the time from PCI hospital entry to balloon passage (DTB) between the two groups [43(29, 103) min vs. 46 (61, 94) min, Z=-0.56, P=0.573]. The compliance rate of FMC2B time<120 min in the transfer group was only 25.9% (50/193). However, the different first-visit hospital had no significant effect on the risk of heart failure ( OR=0.54, 95 %CI:0.16-1.79, P=0.311) and risk of death ( OR=1.14, 95 %CI:0.20-6.36, P=0.885). The results suggest that STEMI patients referred to PCI hospitals have considerable time delay, and the rate of compliance with FMC2B time<120 min is low.
