Related Factors Affecting Rescue Efficiency Before And After Optimizing STEMI Rescue Procedures

Objective:To collect the information of the first ST-segment elevation myocardial infarction(STEMI)patients admitted to the People's Hospital of Hunan Province,and to provide information on all aspects of treatment and follow-up after treatment.Efficacy and follow-up of patients,etc.,to analyze the relevant factors affecting the efficiency of treatment and possible factors of delay in treatment.Evaluate the importance of optimizing the STEMI process and advance the improvement of the STEMI patient care process.Methods:In this study,204 patients with STEMI who were admitted to the Hunan Provincial People's Hospital from May 1,2016 to February 28,2017 were recorded consecutively.The results were recorded on October 1,2016,and were divided into two categories before entering the treatment optimization process.Cases of STEMI were in the control group.142 patients with STEMI after the optimization procedure were entered into the optimized group.The optimization group optimizes the flow through remote transmission of ECG and bypassing emergency treatment.After admission,the nurse asks the patient for basic information,such as academic qualifications,residence registration,spouse status,type of medical insurance,etc.,and fills inthe patient registration form for admission.All patient-related data were filled out by the medical staff first admitted by our hospital for the start-up session,including patient onset time,first medical contact time,time to enter our hospital,informed consent time,signed consent time,balloon expansion time and full During the process,the patient mainly used drugs and coronary interventional treatment.By collecting the above time and calculating the time from onset to first medical contact,onset to balloon expansion time,first medical contact to informed consent,informed consent to signed consent time,first medical contact to signed consent time,first medical contact to Balloon expansion time,entrance to the hospital to the balloon expansion time.Statistical analysis using SPSS20.0 statistical software.The measurement data is expressed as x±s.Normally distributed measurement data are compared using two independent samples of ton test,non-normal distribution measurement data are subjected to rank sum test,and count data are measured using chi-square test or Fisher's exact test.The definition of bilateral P<0.05 difference was statistically significant.Results:Including patients diagnosed with STEMI excluded cases that did not meet the criteria and eventually included 204 patients.1.Comparison of treatment efficiencies before and after the optimization of the treatment process:There was a statistically significant difference between the onset of symptoms and the first medical contact between the two groups(P=0.022),but the time from onset to treatment in the control group was significantly shorter than that of the optimized group.FMC-to-B time(P=0.001),D-to-B time(P=0.001),FMC-to-tell time(P=0.04),informed consent from surgery to signed informed consent(P=0.001)The time between the first medical contact and the signing of informed consent(P=0.001)was statistically significant,and the optimized group was significantly shorter than the control group.2.There was no statistically significant difference between the two groups in the total time of ischemia(P=0.632)between onset of symptoms and expansion of the balloon to achieve reperfusion.The ratio of emergency bypass and remote transmission of electrocardiogram between the two groups was statistically significant.The proportion of emergency bypass and remote transmission of ECG in the optimized group was significantly higher than that in the control group;the composition ratio of patients in the two groups was not statistically significant.difference.3.Follow-up MACE events in the hospital:acute heart failure(P=0.935),in-hospital fatal and non-fatal stroke(P=0.129),recurrence of nosocomial angina(P=0.287),and in-hospital cardiac death(P=0.735)In other events,there was no significant difference between the optimized group and the control group.There was a statistically significant difference between the two groups in malignant arrhythmia(P=0.016).The optimized group was lower than the control group.One-year follow-up of MACE events after discharge:Patient discharged angina(P=0.735),recurrent heart failure(P=0.195),all-cause death(P=0.521),and event-free survival(P=0.780).There was no statistical difference between the groups.4.The age,spouse status,family register,education level,and medical payment method indicators are used as independent variables,and the classification independent variables are assigned,and the S-to-FMC time is taken as the dependent variable and also assigned value,and Logistic regression analysis is performed:the patient's The degree of education is an independent factor that influences the time of S-to-FMC(P<0.05).The higher the degree of education,the better the S-to-FMC time.There was no significant correlation between the age,spouse status,medical payment method,and household registration address,and the patient's S-to-FMC time.Conclusion:1.Optimization of electrocardiogram remote transmission and bypassing emergency treatment,streamlining all aspects of treatment,and shortening treatment time.2.In patients with no improvement in total myocardial ischemia time,hospital MACE events,hospitalization costs,hospital stay,and MACE events outside the hospital for one year did not improve.3.Patients' pre-hospital treatment delays are related to academic qualifications.Highly-educated persons tend to seek prompt medical attention after onset to clarify reasons.Therefore,those with lower academic qualifications who have high academic qualifications'before the hospital delay are shorter.