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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

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학술저널
저자정보
Kyungil Park (Dong-A University Hospital) Jong-Sung Park (Dong-A University Hospital) Young-Rak Cho (Dong-A University Hospital) Tae Ho Park (Dong-A University Hospital) Moo-Hyun Kim (Dong-A University Hospital) Tae-Hyun Yang (Inje University) Doo-IL Kim (Inje University) Jung-Hwan Kim (Dong-Eui Medical Center) Yong-Hwan Lee (Dong Rae Bong Seng Hospital) Dong-Won Lee (Gupo Sungshim Hospital) Jeongkee Seo (BHS Hanseo Hospital) Geun-Young Lee (Metropolitan City Fire and Safety Headquarters) Young-Dae Kim (Dong-A University Hospital)
저널정보
대한심장학회 Korean Circulation Journal Korean Circulation Journal Vol.50 No.8
발행연도
2020.1
수록면
709 - 719 (11page)

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Background and Objectives: In acute ST-segment elevation myocardial infarction (STEMI), on-site transmission of electrocardiogram (ECG) has been shown to reduce systemic time delay to reperfusion and improve outcomes. However, it has not been adopted in community-based emergency transport system in Korea. Methods: Busan Regional Cardio-cerebrovascular Center and Busan Metropolitan City Fire and Safety Headquarters (BMFSH) jointly developed and conducted a pre-hospital ECG transmission program. Seven tertiary hospitals and 22 safety stations of BMFSH participated. Systemic time delay to reperfusion of STEMI patients in the program was compared with that of 95 patients transported by 119 emergency medical system (EMS) before the program was implemented. Results: During the study period, 289 ECG transmissions were made by 119 EMS personnel, executed within 5 minutes in 88.1% of cases. Of these, 42 ECGs were interpreted as ST-segment elevation. Final diagnosis of STEMI was made in 20 patients who underwent primary percutaneous coronary intervention. With the program, systemic time delay to reperfusion was significantly reduced (median [interquartile range; IQR], 76.0 [62.2–98.7] vs. 90.0 [75.0–112.0], p<0.01). Significant reduction of door-to-balloon time was also observed (median [IQR], 45.0 [34.0–69.5] vs. 58.0 [51.0–68.0], p=0.03). The proportion of patients with systemic time delay shorter than 90 minutes rose (51.6% vs. 75.0%, p=0.08) with pre-hospital ECG transmission. Conclusions: We developed and implemented a community-based pre-hospital ECG transmission program for expeditious triage of STEMI patients. Significant reductions of systemic time delay and door-to-balloon time were observed. The expanded use of pre-hospital ECG transmission should be encouraged to realize the full potential of this program.
#ST elevation myocardial infarction #Percutaneous coronary intervention #Triage

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참고문헌 (26)

참고문헌 신청
Denktas AE / 2011 / Total ischemic time : the correct focus of attention for optimal ST-segment elevation myocardial infarction care / JACC Cardiovasc Interv 4:599~604 google schola Francone M / 2009 / Impact of primary coronary angioplasty delay on myocardial salvage, infarct size, and microvascular damage in patients with ST-segment elevation myocardial infarction : insight from cardiovascular magnetic resonance / J Am Coll Cardiol 54:2145~2153 google schola De Luca G / 2004 / Time delay to treatment and mortality in primary angioplasty for acute myocardial infarction : every minute of delay counts / Circulation 109:1223~1225 google schola Bradley EH / 2009 / The door-to-balloon alliance for quality: who joins national collaborative efforts and why? / Jt Comm J Qual Patient Saf 35:93~99 google schola Kim HK / 2017 / Relationship between time to treatment and mortality among patients undergoing primary percutaneous coronary intervention according to Korea Acute Myocardial Infarction Registry / J Cardiol 69:377~382 google schola

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