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| Influence factors of treatment delay in patients with acute myocardial infarction and countermeasures |
| RAO Hanwei ZHONG Ze▲ ZHOU Yan |
| The First People′s Hospital of Jiande, Zhejiang Province, Jiande 311600, China |
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Abstract Objective To discuss the influenc factors of treatment delay in patients with acute ST-segment elevation myocardial infarction (STEMI) and countermeasures. Methods From March 2014 to June 2017, in the First Peoples′ Hospital of Jiande, 304 STEMI patients were selected, the patients′ sex, age, combined disease, personal history, educational level, symptoms, physical examination, laboratory tests, electrocardiogram and other information, record patients to emergency time, electrocardiogram time, call consultation time, preoperative talk time, preoperative preparation time, catheterization room staff in place, operating room preparation time, patients′ DTB time, the correlation between factors and DTB time correlation was observed. Results Among the 304 patients, 238 patients had DTB≤90 min, accounting for 78.29%, and 66 patients had DTB > 90 min, accounting for 21.71%. Electrocardiogram-consultation time, consultation-completion time of conversation in patients with DTB > 90 min were significantly lower than those in patients with DTB≤90 min, the differences were statistically significant (P < 0.05), but emergency-ECG time, preoperative preparation time, catheterization staff in-service time and operating room preparation time were comapared, the differences were not statistically significant (P > 0.05). Univariate analysis showed that ethnicity, age, household location, number of family members, smoking, drinking, hypertension, hyperlipidemia, diabetes and infarction were not the influence factors of DTB time (P > 0.05). Gender, first onset, family monthly income, patients with STEMI, family knowledge of stemi, cost of payment, educational level, history of prior PCI, typical STEMI symptoms, STEMI symptoms, secondary reciprocation, symptoms-non-work-time visits were influence factors of DTB time (P <0.05). Multivariate Logistic analysis showed that first onset and non-working hours were independent risk factors of DTB (P <0.05). Typical clinical symptoms, typical STEMI electrocardiogram, troponin positive, education above junior college were protective factors of DTB (P < 0.05). Conclusion ECG-consultation time, consultation-completed the talk is the main reason for delays caused by DTB, clinic can be given optimize the green channel, optimize the intervention process, optimize conversation skills, and so on, in order to shorten the DTB.
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