Increase in self-presenting patients with ST-elevation myocardial infarction to the emergency department.

IF 0.9 Q2 MEDICINE, GENERAL & INTERNAL
Ronald Manorekang, Alison Eales, James Thomas, Veeran Subramaniam
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引用次数: 0

Abstract

Background: We provide data on self-presenting patients with a diagnosis of ST-elevation myocardial infarction (STEMI) from our local hospitals who were transferred to tertiary centres for primary percutaneous coronary intervention (PPCI).

Methodology: An audit of self-presenting patients with STEMI who underwent PPCI from 1 April 2020 to 31 March 2023. Time variables and post-PPCI results were scrutinised.

Results: A total of 126 patients were reviewed. There was a substantial increase in the number of self-presenting patients from 2020 to 2023 (23, 48 and 55, respectively, each year, p = 0.006). One hundred and one (80%) patients were men and 83 (66%) patients attended during out-of-hours. The median time from patients' registration to having an ECG was 20 min [interquartile range (IQR) 12-38], from ECG to receiving dual anti-platelet was 29 min (IQR 18-52), from a referral made to the regional PPCI centre to when patients left emergency department (ED) was 55 min (IQR 32-79), and total time patients spent in the ED was 126 min (IQR 88-174). One hundred and eleven (88%) patients had PPCI, mostly single vessel and 4 (3%) patients died within 30 days of PPCI.

Conclusion: There is an increasing trend in self-presentation with chest pain diagnosed as STEMI, with suboptimal guideline-directed timely management.

自诉st段抬高型心肌梗死患者急诊人数增加
背景:我们提供了来自我们当地医院诊断为st段抬高型心肌梗死(STEMI)的自我表现患者的数据,这些患者被转移到三级中心进行初级经皮冠状动脉介入治疗(PPCI)。方法:对自2020年4月1日至2023年3月31日接受PPCI的自我表现的STEMI患者进行审计。时间变量和ppci后的结果被仔细检查。结果:共纳入126例患者。从2020年到2023年,自我呈现的患者数量大幅增加(每年分别为23人、48人和55人,p = 0.006)。101例(80%)患者为男性,83例(66%)患者在非工作时间就诊。从患者登记到心电图检查的中位时间为20分钟[四分位间距(IQR) 12-38],从心电图检查到接受双抗血小板治疗的中位时间为29分钟(IQR 18-52),从转诊到地区PPCI中心到患者离开急诊科(ED)的中位时间为55分钟(IQR 32-79),患者在急诊科的总时间为126分钟(IQR 88-174)。111例(88%)患者发生PPCI,多为单血管,4例(3%)患者在PPCI后30天内死亡。结论:胸痛自诉诊断为STEMI的患者呈增加趋势,指导及时治疗的指南不够理想。
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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
81
审稿时长
20 weeks
期刊介绍: The Journal of the Royal College of Physicians of Edinburgh (JRCPE) is the College’s quarterly, peer-reviewed journal, with an international circulation of 8,000. It has three main emphases – clinical medicine, education and medical history. The online JRCPE provides full access to the contents of the print journal and has a number of additional features including advance online publication of recently accepted papers, an online archive, online-only papers, online symposia abstracts, and a series of topic-specific supplements, primarily based on the College’s consensus conferences.
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