Time of day variation in door-to-balloon time for STEMI patients in Los Angeles County: does time of day make a difference?

Acute cardiac care Pub Date : 2013-09-01 Epub Date: 2013-06-05 DOI:10.3109/17482941.2013.776690
David M Shavelle, Ling Zheng, Marcus Ottochian, Brittany Wagman, Nicholas Testa, Stephanie Hall, William Koenig, Linda S Chan, Ray V Matthews
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引用次数: 5

Abstract

Objective: Evaluate treatment times and clinical outcome in a consecutive series of ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) in Los Angeles County.

Background: Primary PCI for STEMI is beneficial if performed in a timely manner. Conflicting data exist regarding potential treatment delays for primary PCI performed during off hours.

Methods: The Emergency Medical Services STEMI Receiving Center Database was queried from 2007 to 2009 to identify patients with a pre-hospital ECG showing STEMI who underwent PCI. On-hour PCI (On-hour Group, n = 1324) was defined as PCI occurring from 8 am to 5 pm and off-hour PCI (Off-hour Group, n = 922) was defined as occurring from 5 pm to 8 am. Treatment times, length of stay, vascular complications, achievement of TIMI 3 flow and in-hospital mortality were evaluated.

Results: Off-hours PCI occurred in 41% of patients. Medical contact to door time was similar in the Off-hour Group compared to the On-hour Group, 20.7 ± 14.6 versus 20.3 ± 12.3 min, respectively, P = 0.47. In patients with available data (n = 1366), the door-to-catheterization laboratory (CL) activation time was significantly shorter in the On-hour Group as compared to the Off-hour Group, -4.9 ± 11.9 versus -0.2 ± 27.5 min, respectively, P < 0.0001. Door-to-balloon time was significantly longer in the Off-hour Group compared to the On-hour Group, 74 ± 35 versus 60 ± 26 min respectively, P < 0.0001. Length of stay, vascular complications, final TIMI 3 flow and in-hospital mortality were similar between both groups.

Conclusions: In STEMI patients receiving primary PCI in Los Angeles County, off-hour PCI was common. Short-term clinical outcomes were similar despite longer door-to-balloon time in patients receiving off-hour PCI. The longer door-to-balloon time in the off-hour PCI patients were partly explained by longer door-to-CL activation time.

洛杉矶县STEMI患者上门到气球时间的时间变化:一天中的时间有区别吗?
目的:评价洛杉矶县ST段抬高型心肌梗死(STEMI)患者连续接受经皮冠状动脉介入治疗(PCI)的治疗时间和临床结果。背景:STEMI的初次PCI治疗如果及时进行是有益的。在非工作时间进行初级PCI的潜在治疗延迟存在矛盾的数据。方法:查询2007年至2009年急诊医疗服务STEMI接收中心数据库,以识别院前心电图显示STEMI并接受PCI治疗的患者。上班时PCI (On-hour Group, n = 1324)定义为发生在上午8点至下午5点的PCI,下班时PCI (off-hour Group, n = 922)定义为发生在下午5点至上午8点的PCI。评估治疗时间、住院时间、血管并发症、TIMI 3流量达到情况和住院死亡率。结果:非工作时间PCI发生率为41%。下班组与上班组的医疗接触时间相似,分别为20.7±14.6 min和20.3±12.3 min, P = 0.47。在有可用数据的患者中(n = 1366),开门到导管实验室(CL)激活时间在开门组明显短于非开门组,分别为-4.9±11.9分钟和-0.2±27.5分钟,P < 0.0001。Off-hour组到球囊的时间明显长于On-hour组,分别为74±35 min和60±26 min, P < 0.0001。两组的住院时间、血管并发症、最终TIMI 3流量和住院死亡率相似。结论:在洛杉矶县接受初级PCI的STEMI患者中,非工作时间PCI很常见。尽管接受非工作时间PCI的患者从门到球囊的时间较长,但短期临床结果相似。非工作时间PCI患者门到球囊时间较长,部分原因是门到cl激活时间较长。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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