David M Shavelle, Ling Zheng, Marcus Ottochian, Brittany Wagman, Nicholas Testa, Stephanie Hall, William Koenig, Linda S Chan, Ray V Matthews
{"title":"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?","authors":"David M Shavelle, Ling Zheng, Marcus Ottochian, Brittany Wagman, Nicholas Testa, Stephanie Hall, William Koenig, Linda S Chan, Ray V Matthews","doi":"10.3109/17482941.2013.776690","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":87385,"journal":{"name":"Acute cardiac care","volume":"15 3","pages":"52-7"},"PeriodicalIF":0.0000,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/17482941.2013.776690","citationCount":"5","resultStr":"{\"title\":\"Time of day variation in door-to-balloon time for STEMI patients in Los Angeles County: does time of day make a difference?\",\"authors\":\"David M Shavelle, Ling Zheng, Marcus Ottochian, Brittany Wagman, Nicholas Testa, Stephanie Hall, William Koenig, Linda S Chan, Ray V Matthews\",\"doi\":\"10.3109/17482941.2013.776690\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":87385,\"journal\":{\"name\":\"Acute cardiac care\",\"volume\":\"15 3\",\"pages\":\"52-7\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2013-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.3109/17482941.2013.776690\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acute cardiac care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3109/17482941.2013.776690\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2013/6/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acute cardiac care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3109/17482941.2013.776690","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2013/6/5 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 5
摘要
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。
Time of day variation in door-to-balloon time for STEMI patients in Los Angeles County: does time of day make a difference?
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.
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