Department of Cardiology, Herz-Jesu-Krankenhaus Dernbach, Südring 8, 56428, Dernbach, Germany.
Institute for Myocardial Infarction Research Foundation Ludwigshafen, University of Heidelberg, Heidelberg, Germany.
Herz. 2021 Apr;46(Suppl 1):89-93. doi: 10.1007/s00059-019-04881-3. Epub 2020 Jan 22.
Chest pain units (CPUs) and stroke units (SUs) provide specialized multidisciplinary in-hospital management for acute chest pain and ischemic stroke. We analyzed exemplary equivalent quality benchmarks in both concepts.
Data from the German CPU registry (2012-2015; 45 certified CPUs, 5881 patients) were compared with data from the SU registry of Rhineland-Palatinate (2011-2015; 29 SUs; 40,380 patients). Parameters comprised demographics, symptoms, diagnosis, medication, critical time intervals, therapeutics, and in-unit outcome.
Non-ST-segment elevation myocardial infarction (47.4%) and ischemic stroke (63.0%) were the most frequent entities. An electrocardiogram was performed on average within 7 min in CPUs, cranial imaging within 49 min in SUs. The mean time interval from admission until coronary intervention or lysis was 42 min or 57 min, respectively. Rates of antiplatelet therapy (90.1% vs. 96.0%), brain imaging, and coronary angiography were high (99.3% vs. 81.1%) and the mortality was low (0.8% for CPUs vs. 3.6% for SUs). The length of stay was shorter in CPUs (1.5 days vs. 4.4 days).
As reimbursement for emergency medicine in Germany was recently rearranged, quality benchmarking has gained incremental importance. Mandatory joint quality measurement in both concepts ensuring gap analysis and process improvement is encouraged.
胸痛单元 (CPU) 和卒中单元 (SU) 为急性胸痛和缺血性卒中提供了专门的多学科院内管理。我们分析了这两个概念中具有代表性的等效质量基准。
比较了来自德国 CPU 注册中心（2012-2015 年；45 个认证 CPU，5881 例患者）的数据与莱茵兰-普法尔茨州 SU 注册中心（2011-2015 年；29 个 SU，40380 例患者）的数据。参数包括人口统计学、症状、诊断、药物治疗、关键时间间隔、治疗和单元内结果。
非 ST 段抬高型心肌梗死（47.4%）和缺血性卒中（63.0%）是最常见的病症。CPU 平均在 7 分钟内进行心电图检查，SU 平均在 49 分钟内进行头部成像。从入院到进行冠状动脉介入或溶栓的平均时间间隔分别为 42 分钟或 57 分钟。抗血小板治疗率（90.1%对 96.0%）、脑成像和冠状动脉造影率高（99.3%对 81.1%），死亡率低（CPU 为 0.8%，SU 为 3.6%）。CPU 的住院时间更短（1.5 天对 4.4 天）。
由于德国最近对急诊医学的报销进行了重新安排，质量基准的重要性日益增加。鼓励在这两个概念中进行强制性联合质量测量，以确保差距分析和流程改进。
