值班心脏病学对二级中心 STEMI 患者再灌注治疗的影响。

Q4 Medicine
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引用次数: 0

摘要

导言和目的由心脏病学专家对心血管疾病患者进行治疗在不同领域都取得了较好的效果。然而,在非三级医院中,心脏病专家值班的情况仍然很少见。方法2006年至2016年期间,一家二级中心连续记录了STEMI。我们对两个时期进行了分析和比较:没有心内科门卫的地区性心脏病治疗网络(2006-2011 年)和有这两种措施的第二个时期(2012-2016 年)。结果 1524 名患者被纳入其中,47.2% 的患者是在心内科值班开始后接受治疗的。我们观察到初级血管成形术的比例有所上升(从 34.3% 上升到 75.7%,P < .001),从门诊到气球植入术的时间缩短了 64 分钟(从 220 [IQR, 167-290] 下降到 156 [IQR, 130-197],P < .001)。这不仅缩短了住院时间,还减少了住院期间的并发症,主要是复发性缺血。虽然住院死亡率有降低的趋势,但随访期间的死亡率并没有因为有心脏病专家值班而发生变化。这不仅缩短了住院时间,还降低了短期死亡率。我们的研究结果表明,设立心脏科警卫能为 STEMI 患者的护理网络带来更多益处:NCT02501070。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impacto de la guardia de cardiología en el tratamiento de reperfusión de los pacientes con IAMCEST en un centro de segundo nivel

Introduction and objectives

The care of patients with cardiovascular disease by specialist in cardiology has shown better results in different spectrums. However, the presence of an on-call cardiologist is still rare in non-tertiary hospitals.

Methods

STEMI was recorded consecutively between 2006 and 2016 in a second level center. We analyzed and compared two periods: regional heart attack care network without a cardiology guard (2006-2011) and a second period (2012-2016) with both measures working.

Results

1524 patients were included, 47.2% after the start of cardiology shift. We observed an increase in primary angioplasty (34.3% to 75.7%, P < .001) as well as a reduction in door-to-balloon time of 64 minutes (220 [IQR, 167-290] to 156 [IQR, 130-197], P < .001). This translates into a shorter hospital stay as well as a reduction in complications during hospitalization, mainly recurrent ischemia. Although there is a trend towards lower hospital mortality, mortality during follow-up did not change with the cardiology guard.

Conclusions

The presence of a cardiologist on call increases the number of patients reperfused, and shortens the time until it. This translates into a shorter hospital stay, as well as lower short-term mortality. Our results indicate that the creation of the cardiological guard brings additional benefit to the care network for patients with STEMI.

ClinicalTrials.gov identifier: NCT02501070.

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来源期刊
REC: CardioClinics
REC: CardioClinics Medicine-Cardiology and Cardiovascular Medicine
CiteScore
0.90
自引率
0.00%
发文量
79
审稿时长
33 days
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