在住院后诊断的ST升高心肌梗塞
Ross F Garberich1, Jay H Traverse, Michael T Claussen
1Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, MN.
Circulation
|January 7, 2014
概括
在住院后经历ST升高心肌梗塞 (STEMI) 的患者面临更长的治疗时间和更高的死亡率. 这一高风险群体需要在STEMI协议中特别注意,以改善结果.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 医疗保健管理的管理
背景情况:
- ST升高心肌梗塞 (STEMI) 治疗时间有所改善,特别是对于紧急医疗服务 (EMS) 患者.
- 关于在症状出现之前被送往医院的患者的STEMI治疗时间和结果的数据有限.
研究的目的:
- 评估住院后发展STEMI的患者的特征和结果.
- 为了比较住院的STEMI患者与通过EMS或自我运输的患者.
主要方法:
- 对未来区域STEMI计划数据库的分析 (2003年3月至2013年1月).
- 包括3795名连续的STEMI患者,重点关注990名 (26.1%) 最初提交给PCI设施.
- 分类为EMS,自主/家庭驱动,和在医院介绍组.
主要成果:
- 在医院住院的STEMI患者年龄较大,体重指数较高,并患有诸如高血压等并发症.
- 与EMS (51分钟) 相比,住院患者的门到气球时间更长 (76分钟).
- 住院患者的住院时间更长 (5天 vs. 3天) 和1年死亡率明显更高 (16.9% vs. 7.1-10.3%).
结论:
- 在医院住院的STEMI患者代表着一个独特的,高风险的人群.
- 与其他STEMI呈现相比,这些患者面临延迟治疗和更糟糕的结果.
- 对于这种脆弱的患者子组,需要进一步的研究和量身定制的战略.
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