Ronald Manorekang, Alison Eales, James Thomas, Veeran Subramaniam
{"title":"自诉st段抬高型心肌梗死患者急诊人数增加","authors":"Ronald Manorekang, Alison Eales, James Thomas, Veeran Subramaniam","doi":"10.1177/14782715251342287","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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).</p><p><strong>Methodology: </strong>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.</p><p><strong>Results: </strong>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, <i>p</i> = 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.</p><p><strong>Conclusion: </strong>There is an increasing trend in self-presentation with chest pain diagnosed as STEMI, with suboptimal guideline-directed timely management.</p>","PeriodicalId":46606,"journal":{"name":"Journal of the Royal College of Physicians of Edinburgh","volume":" ","pages":"94-97"},"PeriodicalIF":0.9000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Increase in self-presenting patients with ST-elevation myocardial infarction to the emergency department.\",\"authors\":\"Ronald Manorekang, Alison Eales, James Thomas, Veeran Subramaniam\",\"doi\":\"10.1177/14782715251342287\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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).</p><p><strong>Methodology: </strong>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.</p><p><strong>Results: </strong>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, <i>p</i> = 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.</p><p><strong>Conclusion: </strong>There is an increasing trend in self-presentation with chest pain diagnosed as STEMI, with suboptimal guideline-directed timely management.</p>\",\"PeriodicalId\":46606,\"journal\":{\"name\":\"Journal of the Royal College of Physicians of Edinburgh\",\"volume\":\" \",\"pages\":\"94-97\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Royal College of Physicians of Edinburgh\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/14782715251342287\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Royal College of Physicians of Edinburgh","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/14782715251342287","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Increase in self-presenting patients with ST-elevation myocardial infarction to the emergency department.
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.
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.