Terkelsen C J
Department of cardiology B, Aarhus University Hospital in Skejby, Skejby, Denmark,
Herz. 2014 Sep;39(6):672-6. doi: 10.1007/s00059-014-4125-y.
International guidelines for the management of patients with ST-elevation myocardial infarction (STEMI) recommend various performance measures to monitor the quality of STEMI systems of care. Door-to-balloon (D2B) time (arrival at hospital to percutaneous coronary intervention, PCI) and overall health care system delay (first medical contact to reperfusion) are acknowledged as valuable performance measures when treating patients with primary percutaneous coronary intervention (PPCI). However, there is confusion regarding the exact definition of these performance measures, and moreover system delay and PCI-related delay (the extra delay acceptable to perform PPCI instead of fibrinolysis) are often used synonymously, which add confusion when considering reperfusion strategy. The present paper calls for a consensus regarding the use and definition of objective performance measures when treating patients with STEMI, and exemplifies why it is insufficient just to focus on D2B time.
ST段抬高型心肌梗死（STEMI）患者管理的国际指南推荐了各种绩效指标，以监测STEMI护理系统的质量。门球时间（从到达医院至经皮冠状动脉介入治疗，PCI）和整体医疗系统延迟（首次医疗接触至再灌注）在治疗接受直接经皮冠状动脉介入治疗（PPCI）的患者时，被公认为是有价值的绩效指标。然而，这些绩效指标的确切定义存在混淆，此外，系统延迟和PCI相关延迟（进行PPCI而非溶栓治疗可接受的额外延迟）经常被同义使用，这在考虑再灌注策略时增加了混淆。本文呼吁在治疗STEMI患者时，就客观绩效指标的使用和定义达成共识，并举例说明仅关注门球时间为何是不够的。
