农村的EMS STEMI患者 - - 为什么要推迟进行PCI?
Jason P Stopyra1, Anna C Snavely1,2, Nicklaus P Ashburn1,2
1Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Prehospital emergency care
|January 18, 2024
概括
近40%的农村ST升高心肌梗塞 (STEMI) 患者没有及时接受再输血. 与男性相比,女性在治疗中经历了显著的延迟,突出了紧急心脏护理的关键医疗保健差异.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- ST升高心肌梗塞 (STEMI) 需要快速的再输血治疗.
- 及时治疗对于改善STEMI患者的治疗结果至关重要.
- 识别影响治疗延迟的因素对于优化护理至关重要.
研究的目的:
- 确定患者和紧急医疗服务 (EMS) 机构与农村STEMI患者及时再输血相关的因素.
- 分析实现90分钟第一次医疗接触 (FMC) 到穿皮冠状动脉干预 (PCI) 目标的差异.
主要方法:
- 来自北卡罗来纳州农村EMS机构的365名成年STEMI患者的队列研究 (2016-2020年).
- 从区域STEMI注册表中抽取的数据,包括医院前和住院时间.
- 用于评估与满足90分钟FMC到PCI目标相关的因素的概括估计方程,考虑机构集群.
主要成果:
- 60.5%的STEMI患者实现了90分钟的FMC到PCI目标.
- 与男性相比,女性实现时间目标的可能性明显低 (45.5%与69.8%,p < 0.001).
- 男性性别独立地与满足FMC到PCI目标的更高可能性有关 (aOR:2.94).
结论:
- 近40%的农村STEMI患者没有在推的90分钟时间内接受再输血.
- 妇女代表了一个脆弱的人群,在STEMI再注射治疗中经历了延迟.
- 解决这些差异对于改善对STEMI患者的公平护理至关重要.
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