心肌梗死患者到急诊科就诊的时间：早晨发病优势的消失。
Presentation Times of Myocardial Infarctions to the Emergency Department: Disappearance of the Morning Predominance.
机构信息
Department of Emergency Medicine, Grand Strand Medical Center, Myrtle Beach, South Carolina.
Department of Emergency Medicine, Grand Strand Medical Center, Myrtle Beach, South Carolina; Department of Surgery, University of South Carolina School of Medicine - Columbia, Columbia, South Carolina.
出版信息
J Emerg Med. 2020 May;58(5):741-748. doi: 10.1016/j.jemermed.2020.01.002. Epub 2020 Mar 27.
BACKGROUND
Previous studies show that myocardial infarctions (MIs) occur most frequently in the morning.
OBJECTIVES
We hypothesized that there no longer is a morning predominance of MI, and that the timing of ST-elevation myocardial infarction (STEMI) vs. non-ST-elevation myocardial infarction (NSTEMI) presentation differs.
METHODS
We reviewed MI, STEMI, and NSTEMI patients (2013-2017) from a multiple-hospital system, identified by diagnostic codes. Daily emergency department arrival times were categorized into variable time intervals for count and proportional analysis, then examined for differences.
RESULTS
There were 18,663 MI patients from 12 hospitals included in the analysis. Most MIs occurred between 12:00 pm and 5:59 pm (35.7%), and least between 12:00 am-5:59 am (16.3%). After subdividing all MIs into STEMIs and NSTEMIs, both groups continued to have the greatest presentation between 12:00 pm and 5:59 pm (33.1% and 36.0%, respectively). STEMIs (17.2%) and NSTEMIs (16.2%) were least frequent between 12:00 am and 5:59 am. We found the second most common presentation time for MIs was in the 6 pm-11:59 pm time period, which held true for both subtypes (MI 26.7%, STEMI 26.4%, NSTEMI 26.7%).
CONCLUSIONS
These data suggest a potential shift in the circadian pattern of MI, revealing an afternoon predominance for both STEMI and NSTEMI subtypes.
背景
先前的研究表明，心肌梗死（MI）最常发生在早晨。
目的
我们假设 MI 不再存在早晨高发的情况，并且 ST 段抬高型心肌梗死（STEMI）与非 ST 段抬高型心肌梗死（NSTEMI）的发病时间不同。
方法
我们回顾了来自多医院系统的 MI、STEMI 和 NSTEMI 患者（2013-2017 年），这些患者是通过诊断代码确定的。将每日急诊部到达时间分为可变时间间隔进行计数和比例分析，然后检查差异。
结果
在纳入分析的 12 家医院的 18663 例 MI 患者中，大多数 MI 发生在下午 12：00 至下午 5：59（35.7%），发生在凌晨 12：00 至上午 5：59 之间的最少（16.3%）。将所有 MI 进一步细分为 STEMI 和 NSTEMI 后，两组在下午 12：00 至下午 5：59 之间的就诊人数最多（分别为 33.1%和 36.0%）。STEMI（17.2%）和 NSTEMI（16.2%）在凌晨 12：00 至上午 5：59 之间就诊人数最少。我们发现 MI 的第二常见发病时间是下午 6：00 至晚上 11：59，这在两种亚型中均如此（MI 26.7%，STEMI 26.4%，NSTEMI 26.7%）。
结论
这些数据表明 MI 的昼夜节律模式可能发生了变化，揭示了 STEMI 和 NSTEMI 两种亚型均以下午高发的情况。
Zotero 插件