The Research Into The Time Distribution Of In-hospital Treatment Delay And The Influential Factors In Patients With Acute St-segment Elevation Myocardial Infarction

Objectives:To investigate the delay in time from door to balloon and to evaluate the factors associated with the delay in diferent phases in patients with the acute ST-elevation mycordial infarction (STEMI), appraising whether current clinical practices are consistent with the guidelines of STEMI about door-to-balloon time.Methods:1. The clinical data of STEMI patients in old hospital campus:Between July2013and december2013,53patients were successfully received percutaneous coronary intervention (PCI) treatment in old Tianjin Chest Hospital campus and all patients clinical data were complete. The general information of these patients were retrospectively anslysed, jncluding demographic characteristics, risk facors associated with coronary heart disease, previous coronary heart disease history, accurate door-to-balloon time (including door to consent of PPCI time, catheter room preparation time, in-hospital transportation and preoperative preparation time, needle-to-balloon time).2. The clinical data of STEMI patients in new hospital campus:Between january2014and march2014,42patients were successfully received percutaneous coronary intervention (PCI) treatment in new Tianjin Chest Hospital campus and all patients clinical data were complete. The general information of these patients were retrospectively anslysed, jncluding demographic characteristics, risk facors associated with coronary heart disease, previous coronary heart disease history, accurate door-to-balloon time (including door to consent of PPCI time, catheter room preparation time, in-hospital transportation and preoperative preparation time, needle-to-balloon time).3. All data was analyzed through SPSS software (version18.0), and P<0.05was of statistically significant difference.Results:1. The door-to-balloon time of the new-hospital patients who received primary percutaneous coronary intervention with STEMI, were remarkablly reduced (P< 0.05). Among these, the door to consent of PPCI, the set-up time of catheter room, the transit and preoperative preparation time were remarkablly reduced (P<0.05), but the needle-to-balloon time were no statistical differences (P>0.05).2. The average door-to-balloon time of the new-hospital patients who received primary percutaneous coronary intervention with STEMI, was91.43±21.99min. The rate of reaching the guidelines of STEMI was54.76%, remarkablly higher than the old-hospital period (P<0.05).3. The factors associated with the DTB getting longger in Logistic regression were female and type2diabetes mellitus (P<0.05). The factor associated with the DTB getting decrease was the previous medical history of coronary heart disease (P<0.05).Conclision:1. The treament model of paitents with STEMI in new hospital campus is "Emergency-Catheter room-CCU", which could remarkablly reduce the in-hospital treatment delay.2. The factors, female and type2diabetes mellitus, may extend the door-to-balloon time. The previous medical history of coronary heart disease could be protective.3. The guidelines of STEMI about door-to-balloon time was executed well in the new Tianjin Chest Hospital campus.4. This study shows that the "door-to-ballon" time of a number of STEMI patients has not yet meet the requirement. All medical personnel should further strengthen their professtional skills, simplify admisson procesure, shorten in-hospital delay. The medical and public health departments should furhter publicize emergency cardiac care knwledge and educate those with high risk of myocardial infarction during out of hospital.