Bruyninckx Rudi, Van den Bruel Ann, Aertgeerts Bert, Van Casteren Viviane, Buntinx Frank
Department of General Practice, ACHG KULeuven, Leuven, Belgium.
Eur J Emerg Med. 2008 Dec;15(6):330-3. doi: 10.1097/MEJ.0b013e328302c840.
Patients with an acute coronary syndrome should be referred to hospital urgently to start reperfusion therapy as soon as possible. Owing to the risks of ventricular fibrillation and pulseless ventricular tachycardia, urgent transport should be organized under safe conditions, that is, with a defibrillator at hand.
To evaluate the type of transport of patients with chest pain referred by their general practitioner (GP).
Observational study.
A sentinel network of general practices in Belgium, covering almost 1.6% of the total population.
One thousand nine hundred and ninety-six patients with chest pain attending their GP in 2003.
Descriptive analyses reporting proportions along with their 95% confidence interval (CI).
Male patients were referred to hospital more often than female patients: 44.9% (95% CI: 41.6-47.8) versus 36.5% (95% CI: 33.4-39.6). For patients who were referred routinely, 92.7% (95% CI: 89.1-95.2) were transported by family and neighbours, 4.8% (95% CI: 2.8-7.9) by ambulance and 2.5% (95% CI: 1.2-5.1) by GPs. For patients who were referred urgently, ambulances transported 56.9% (95% CI: 51.1-62.7), family and neighbours 36.9% (95% CI: 31.4-42.7) and the GP 6.1% (95% CI: 3.7-9.5).
Almost half of the patients with chest pain who require urgent referral are transported in unsafe conditions.
急性冠状动脉综合征患者应紧急转诊至医院，以便尽快开始再灌注治疗。由于存在室颤和无脉性室性心动过速的风险，应在安全条件下组织紧急转运，即手头配备除颤器。
评估由全科医生（GP）转诊的胸痛患者的转运方式。
观察性研究。
比利时一个全科医疗哨点网络，覆盖总人口的近1.6%。
2003年因胸痛就诊于全科医生的1996例患者。
描述性分析，报告比例及其95%置信区间（CI）。
男性患者比女性患者更常被转诊至医院：44.9%（95%CI：41.6 - 47.8）对36.5%（95%CI：33.4 - 39.6）。对于常规转诊的患者，92.7%（95%CI：89.1 - 95.2）由家人和邻居转运，4.8%（95%CI：2.8 - 7.9）由救护车转运，2.5%（95%CI：1.2 - 5.1）由全科医生转运。对于紧急转诊的患者，救护车转运56.9%（95%CI：51.1 - 62.7），家人和邻居转运36.9%（95%CI：31.4 - 42.7），全科医生转运6.1%（95%CI：3.7 - 9.5）。
几乎一半需要紧急转诊的胸痛患者是在不安全的条件下转运的。
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