Factors Influencing Pre-Hospital Time In Patients With First ST-Segment Elevation Myocardial Infarction

Objectives To explore the influencing factors of pre-hospital time in patients with first-episode acute ST-segment elevation myocardial infarction(STEMI),so as to provide a theoretical basis for shortening the pre-hospital time and improving the treatment rate of patients.Methods A total of 663 first-episode STEMI and emergency PCI patients admitted to Tangshan Workers’Hospital from January 1,2016 to December 31,2018 were enrolled.Relevant data of the patients were collected,including pre-hospital time,general condition,morbidity,past history,personal history and family history.According to the pre-hospital time,the patients were divided into 4 groups,including≤3 hours,3-6 hours,6-12 hours and>12 hours,and the distribution of pre-hospital time was observed.χ~2 test and Fisher’s exact test were used for single factor analysis of pre-hospital time.Multiple linear regression analysis was conducted for multi-factor analysis of pre-hospital time.Results 1 Pre-hospital time distribution:the median value of pre-hospital time was 6(4,9)hours,17.0%(n=113)in≤3 hours group,38.8%(n=257)in 3-6 hours group,29.9%(n=198)in 6-12 hours group,and 14.3%(n=95)in>12 hours group.2 Single factor analysis of pre-hospital time:the following factors had an effect on pre-hospital time,with statistically significant differences:gender(P=0.016),age(P=0.022),education level(P=0.001),occupation(P<0.001),medical insurance(P<0.001),BMI(P=0.025),admission mode(P<0.001)and smoking history(P=0.048).In terms of different pre-hospital time periods,with the extension of pre-hospital time,the proportion of female,age≥60 years old,peasants,medical insurance and indirect admission tended to increase with the extension of pre-hospital time,while the distribution of primary school and below,BMI≥24kg/m~2 and non-smoking showed no regularity.3 Multi-factor analysis of pre-hospital time:multiple linear regression analysis was performed,with pre-hospital time as the dependent variable,and the factors above mentioned as independent variables.The results showed that admission mode and smoking history were the influencing factors.Indirect admission(β=-0.113,P<0.001)and non-smokers(β=-0.048,P=0.047)were risk factors for prehospital delay.Conclusions The first-episode STEMI patients in this region had a long pre-hospital time,with the pre-hospital time within 3 hours accounting for only 17%.The influencing factors of pre-hospital time included gender,age,education level,occupation,medical insurance,BMI,admission mode and smoking history.Indirect admission and non-smoking were independent risk factors of prehospital time delay.Figure 1;Table 10;Reference 125...