Community-Based Pre-Hospital Electrocardiogram Transmission Program for Reducing Systemic Time Delay in Acute ST-Segment Elevation Myocardial Infarction

被引：9

作者：

Park, Kyungil ^{[1
,2
]}

Park, Jong-Sung ^{[1
,2
]}

Cho, Young-Rak ^{[1
,2
]}

Park, Tae-Ho ^{[1
,2
]}

Kim, Moo-Hyun ^{[1
,2
]}

Yang, Tae-Hyun ^{[3
]}

Kim, Doo-Il ^{[4
]}

Kim, Jung-Hwan ^{[5
]}

Lee, Yong-Hwan ^{[6
]}

Lee, Dong-Won ^{[7
]}

Seo, Jeongkee ^{[8
]}

Lee, Geun-Young ^{[9
]}

Kim, Young-Dae ^{[1
,2
]}

机构：

[1] Dong A Univ, Dong Univ Hosp A, Dept Cardiol, Coll Med, Busan, South Korea

[2] Dong A Univ Hosp, Busan Reg Cardio Cerebrovasc Ctr, Cardiovasc Ctr, 26 Daesingongwon Ro, Busan 49201, South Korea

[3] Inje Univ, Univ Baek Hosp, Dept Inje, Coll Med, Busan, South Korea

[4] Inje Univ, Coll Med, Dept Cardiol, Haeundae Baek Hosp, Busan, South Korea

[5] Dong Eui Med Ctr, Dept Cardiol, Busan, South Korea

[6] Dong Rae Bong Seng Hosp, Dept Cardiol, Busan, South Korea

[7] Gupo Sungsh Hosp, Dept Cardiol, Busan, South Korea

[8] BHS Hanseo Hosp, Dept Cardiol, Busan, South Korea

[9] Metropolitan City Fire & Safety Headquarters, Busan, South Korea

来源：

KOREAN CIRCULATION JOURNAL | 2020年 / 50卷 / 08期

关键词：

ST elevation myocardial infarction; Percutaneous coronary intervention; Triage; PRIMARY CORONARY ANGIOPLASTY; TO-BALLOON TIME; 12-LEAD ELECTROCARDIOGRAM; MORTALITY; INTERVENTION; REPERFUSION; OUTCOMES; TRIAGE; IMPACT; REGISTRY;

D O I：

10.4070/kcj.2019.0337

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background and objectives: In acute ST-segment elevation myocardial infarction (STEMI), on-site transmission of electrocardiogram (ECG) has been shown to reduce systemic time delay to reperfusion and improve outcomes. However, it has not been adopted in community-based emergency transport system in Korea. Methods: Busan Regional Cardio-cerebrovascular Center and Busan Metropolitan City Fire and Safety Headquarters (BMFSH) jointly developed and conducted a pre-hospital ECG transmission program. Seven tertiary hospitals and 22 safety stations of BMFSH participated. Systemic time delay to reperfusion of STEMI patients in the program was compared with that of 95 patients transported by 119 emergency medical system (EMS) before the program was implemented. Results: During the study period, 289 ECG transmissions were made by 119 EMS personnel, executed within 5 minutes in 88.1% of cases. Of these, 42 ECGs were interpreted as ST-segment elevation. Final diagnosis of STEMI was made in 20 patients who underwent primary percutaneous coronary intervention. With the program, systemic time delay to reperfusion was significantly reduced (median [interquartile range; IQR], 76.0 [62.2-98.7] vs. 90.0 [75.0-112.0], p<0.01). Significant reduction of door-to-balloon time was also observed (median [IQR], 45.0 [34.0-69.5] vs. 58.0 [51.0-68.0], p=0.03). The proportion of patients with systemic time delay shorter than 90 minutes rose (51.6%vs. 75.0%, p=0.08) with pre-hospital ECG transmission. Conclusions: We developed and implemented a community-based pre-hospital ECG transmission program for expeditious triage of STEMI patients. Significant reductions of systemic time delay and door-to-balloon time were observed. The expanded use of prehospital ECG transmission should be encouraged to realize the full potential of this program.

引用

页码：709 / 719

页数：11

共 26 条

[1] Relationship between delay in performing direct coronary angioplasty and early clinical outcome in patients with acute myocardial infarction - Results from the Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes (GUSTO-IIb) Trial [J].