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Implementation of specialty centers for patients with st-segment elevation myocardial infarction

机译：设立st段抬高型心肌梗死患者专科中心

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Background. Early percutaneous coronary intervention (PCI) has been shown to be superior to fibrinolytic therapy andis associated with reduced morbidity andmortality for patients with ST-segment elevation myocardial infarction (STEMI). Objective. To determine the performance of a regional system with prehospital 12-lead electrocardiogram (ECG) identification of STEMI patients anddirect paramedic transport to STEMI receiving centers (SRCs) for provision of primary PCI. Methods. This was a prospective study evaluating the first year of implementation of a regional SRC network to determine the key time intervals for patients identified with STEMI in the prehospital setting. Results. During the 12-month study period, 1,220 patients with a suspected STEMI were identified on prehospital 12-lead ECG, of whom 734 (60) underwent emergency PCI. A door-to-balloon time of 90 minutes or less was achieved for 651 (89) patients, and459 (62.5) had EMSpatient contact-to-balloon times ≤ 90 minutes. Transport of suspected STEMI patients to an SRC resulted in ambulance diversion from a closer ED for 31 of patients anda median increase in transport time of 3.8 minutes. Conclusion. Door-to-balloon times within the 90-minute benchmark were achieved for almost 90 of STEMI patients transported by paramedics after implementing our regionalized SRC system
机译：背景。早期经皮冠状动脉介入治疗（PCI）已被证明优于纤溶治疗，并且与ST段抬高型心肌梗死（STEMI）患者的发病率和死亡率降低相关。目的。通过院前12导联心电图（ECG）识别STEMI患者并直接将辅助医疗人员运送到STEMI接收中心（SRC）以提供主要PCI来确定区域系统的性能。方法。这是一项前瞻性研究，评估实施区域性SRC网络的第一年，以确定院前环境中STEMI确诊患者的关键时间间隔。结果。在为期12个月的研究期内，通过院前12导联心电图确定了1,220例可疑STEMI患者，其中734例（60）接受了紧急PCI。 651（89）位患者的上气球时间达到了90分钟或更短，而EMS患者接触气球的时间≤90分钟达到459（62.5）位。将可疑的STEMI患者转运至SRC导致31名患者从较近的ED转移了救护车，转运时间中位数增加了3.8分钟。结论。在实施我们的区域性SRC系统后，几乎90名由医护人员转运的STEMI患者在90分钟的基准时间内达到了上气球时间

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