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葡萄牙的“生命支架”计划:这一倡议将持续存在。

Stent for Life in Portugal: This initiative is here to stay.

作者信息

Pereira Hélder, Pinto Fausto J, Calé Rita, Pereira Ernesto, Marques Jorge, Almeida Manuel, de Mello Sofia, Dias Martins Luís

机构信息

Cardiology Dpt, Hospital Garcia de Orta, Almada, Portugal.

Cardiology Dpt, CCUL, CAML, University of Lisbon, Portugal.

出版信息

Rev Port Cardiol. 2014 Jun;33(6):363-70. doi: 10.1016/j.repc.2014.02.013. Epub 2014 Jul 3.

Abstract

AIMS

Portugal has one of the lowest rates of primary percutaneous coronary intervention (p-PCI) in Western Europe. This study assessed the progress of Portuguese p-PCI performance indicators one year after Portugal joined the Stent for Life (SFL) initiative.

METHODS AND RESULTS

Two national surveys were carried out, each covering a period of one month: the first when Portugal joined the SFL in 2011 (Moment Zero), and the second one year later (Moment One). A total of 397 consecutive patients with probable ST-segment elevation myocardial infarction were enrolled (201 at Moment Zero and 196 at Moment One) from 15 centers. During this period, the number of patients who arrived at a local hospital without p-PCI decreased (62-47%; p=0.004) and transportation to a p-PCI hospital by the National Institute for Medical Emergencies (INEM) increased significantly (13-37%; p<0.001). Shorter times to revascularization were observed, due to shorter patient delay (118-102 min; p=0.008). Door-to-balloon delay and system delay remained unchanged.

CONCLUSIONS

Improvements in performance indicators for p-PCI demonstrate the success of the first year of the local SFL plan, which was mainly focused on raising public awareness of the need to use the INEM emergency services, which has reduced patient delay, and on improving secondary transportation.

摘要

目的

葡萄牙是西欧地区初级经皮冠状动脉介入治疗(p-PCI)率最低的国家之一。本研究评估了葡萄牙加入“生命支架”(SFL)计划一年后其p-PCI性能指标的进展情况。

方法与结果

开展了两项全国性调查,每项调查为期一个月:第一次是在2011年葡萄牙加入SFL时(零时刻),第二次是在一年后(一时刻)。从15个中心共纳入了397例连续的疑似ST段抬高型心肌梗死患者(零时刻201例,一时刻196例)。在此期间,未接受p-PCI而抵达当地医院的患者数量减少(从62%降至47%;p = 0.004),国家医疗急救研究所(INEM)将患者转运至具备p-PCI能力医院的情况显著增加(从13%增至37%;p < 0.001)。由于患者延误时间缩短(从118分钟降至102分钟;p = 0.008),血管再通时间缩短。门球时间和系统延误保持不变。

结论

p-PCI性能指标的改善证明了当地SFL计划第一年的成功,该计划主要侧重于提高公众对使用INEM紧急服务必要性的认识,这减少了患者延误,并改善了二次转运情况。

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