在上班时间和下班时间呈现的急性冠状动脉综合征:第三级心血管中心有区别吗?
Ivan Ilic1,2, Anja Radunovic1, Milica Matic1
1Institute for Cardiovascular Diseases Dedinje, Heroja Milana Tepića 1, 11000 Belgrade, Serbia.
Medicina (Kaunas, Lithuania)
|August 26, 2023
概括
在上班期间因急性冠状动脉综合征 (ACS) 住院的患者有更复杂的冠状动脉疾病 (CAD),并接受更苛刻的皮肤冠状动脉干预 (PCI),导致较高的重大心脑不良事件 (MACCE) 发生率. 结果因入院时间而异.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 公共卫生 公共卫生
背景情况:
- 急性冠状动脉综合征 (ACS) 需要及时干预,但治疗和结果可能因医院工作时间而异.
- 了解这些变化对于优化患者护理和资源配置至关重要.
研究的目的:
- 调查在工作时间内与工作时间以外接受ACS治疗的患者临床特征和治疗结果的差异.
- 根据入院时间确定治疗和患者管理中的潜在差异.
主要方法:
- 对1873名连续接受冠状动脉血管造影和干预的ACS患者的回顾性研究.
- 工作时间定义为周一至周五,07:30-14:30;下班时间包括所有其他时间.
- 在上班时间和下班时间之间的患者人口统计,临床表现,程序细节和临床结果的比较.
主要成果:
- 在办公时间以外的入院有更多的男性和STEMI,而在办公时间内的入院则有更多的先前MI和NSTEMI.
- 在工作时间的患者出现了更多的多血管疾病 (MVD),并接受了更多的多血管PCI.
- 主要心脑不良事件 (MACCEs) 在工作时间组中更频繁,与更高的重复PCI率有关.
结论:
- 在上班期间入院的ACS患者表现出更复杂的冠状动脉疾病 (CAD).
- 这些患者需要更复杂的干预措施,并且经历了更高的MACCE率,通常与心肌梗塞和重复手术有关.
- 住院时间影响患者表现,干预复杂性和ACS管理中的临床结果.
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