An Analysis Of The "Door To Signature" Time And Its Influencing Factors In STEMI Patients

ObjectiveTo investigate time for obtaining informed consent in primary percutaneous coronary intervention(PCI)and its influence factors in patients with ST segment elevation myocardial infarction(STEMI)in Henan Provincial People's Hospital.The aim is to provide a scientific basis for further effective shortening the time of primary PCI in patients with STEMI.Method1.A total of 226 patients who were diagnosed with STEMI and underwent primary PCI in Henan Provincial People's Hospital from August 2015 to December 2016 were enrolled in the study.2.Observation indicators:(1)?aseline data of patients(gender,age,education level,occupation,history of hypertension,diabetes,blood lipid level,smoking,Killip classification and left ventricular ejection fraction)were collected.(2)Time segments in primary PCI: total ischemic time(TIT),door to balloon time(DT?T),obtaining informed consent time(OICT),signaturing to balloon time(ST?T).(3)The demographic characteristics of the family members who signed informed consent(name,the relationship,sex,age,education level,occupation,residence,the number of family members).(4)the psychological factors and coping strategies of family members before signing informed consent.4.Statistical Analyses: All data was analyzed through SPSS software(version 22.0).The ratio analysis method was used to analyze the proportion of OICT in the DT?T and the TIT,multiple linear regression analysis was used to analyze the influencing factors of delay of OICT,and P<0.05 was of statistically significant difference.Result:1.In this study,226 patients with STEMI who were first diagnosed in our hospital had a mean age of was 55.23±10.80 years,and 181(80.1%)were male,45(19.9%)were female.2.The median and quartile range of TIT,DT?T,OICT,ST?T in 226 patients with STEMI were 312(256,361)min,166(127,210)min,82(50,130)min,80(70,90)min.The ratio of OICT in DTBT and TIT was 50% and 28.5%,respectively.3.Analysis of the association factors related with OICT.The multiple linear regression analysis of factors of OICT,which showed that the number of family members,the educational leval and residence of family members,the medical cost is too high,the family members have consulted each other repeatedly,and consulted the other medical staff(the so-called "find acquaintances")contributed to OICT.Among them,the number of direct family members(B =8.386,t=2.346,P < 0.001),the educational leval in middle school and below(B =22.930,t=2.595,P=0.010),high school /polytechnic school(B =19.272,t=2.193,P=0.029),the medical cost is too high(B =21.947,t=2.345,P=0.020),he family members have consulted each other repeatedly(B =27.192,t=2.316,P=0.022),consulted the other medical staff(the so-called "find acquaintances")(B =27.192,t=2.316,P=0.022)are risk factors of OICT,and the residence is the city(B =-15.919,t=-1.989,P=0.048)is the protection factor of OICT.Conclusion1.The time for "obtaining informed consent" is too long that is a reality of the practice of primary PCI in China.2.The factors that lead to longer OICT include the demographic characteristics,psychological factors and coping strategies of family members.The significantly longer OICT can be accounted for the family members of demographic characteristics,psychological factors,coping strategies.3.According to the guide,the DTB time is incompatible with the national conditions.The STBT is a medical quality control index of the primary PCI in China.