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新型冠状病毒肺炎大流行对沙特阿拉伯一家三级医疗中心ST段抬高型心肌梗死患者临床表现及医院管理的影响

The Impact of COVID-19 Pandemic on the Presentation and Hospital Management of STEMI Patients in a Tertiary Care Center in Saudi Arabia.

作者信息

Balghith Mohammed Ali

机构信息

King Abdulaziz Cardiac Center, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.

出版信息

Heart Views. 2020 Jul-Sep;21(3):166-170. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_128_20. Epub 2020 Oct 13.

DOI:10.4103/HEARTVIEWS.HEARTVIEWS_128_20
PMID:33688408
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7898991/
Abstract

BACKGROUND

The COVID-19 Pandemic has put enormous pressure on the healthcare system globally, causing many healthcare organizations to cancel elective admission for coronary angiograms. The purpose of this study is to assess changes in ST segment elevation myocardial infarction (STEMI) practice, including the number of patients, door to balloon time and time from the onset of symptoms until reperfusion therapy in a tertiary center in Saudi Arabia.

METHODS

This is a single center retrospective observational study, comparing all STEMI patients in the last five months of 2019 (Pre-COVID-19 period) with the first 5 months of 2020 (COVID -19 period) in regards to the volume of STEMI patients, symptoms onset to ER arrival time, door to balloon timing and the reperfusion therapy strategy.

RESULTS

A total number of 173 STEMI patients were analyzed; 81 STEMI patients in the Pre-COVID-19 period and 92 STEMI patients in the COVID-19 period. When compared with pre-COVID period, there was a statistically non-significant increase in STEMI patients (12%), slight delay in the door to balloon timing; 94 vs 87 minutes. As well, there was more delay from onset of symptoms to presentation to the ER (>12 hours from symptoms onset to ER arrival (16% vs, 4% in group 1). Primary percutaneous coronary intervention (PPCI) was the main modality between the 2 groups without significant differences (100% Pre-COVID vs. 97% COVID-19 period).

CONCLUSION

There was some delay of STEMI patient's presentation to the hospital during Covid-19 timing, without significant changes in the medical practice of care.

摘要

背景

新冠疫情给全球医疗系统带来了巨大压力,导致许多医疗机构取消了冠状动脉造影的择期入院安排。本研究的目的是评估沙特阿拉伯一家三级中心ST段抬高型心肌梗死(STEMI)的治疗变化,包括患者数量、门球时间以及从症状发作到再灌注治疗的时间。

方法

这是一项单中心回顾性观察研究,比较2019年最后五个月(新冠疫情前时期)和2020年前五个月(新冠疫情时期)所有STEMI患者的STEMI患者数量、症状发作至急诊到达时间、门球时间和再灌注治疗策略。

结果

共分析了173例STEMI患者;新冠疫情前时期有81例STEMI患者,新冠疫情时期有92例STEMI患者。与新冠疫情前时期相比,STEMI患者数量有统计学上无显著意义的增加(12%),门球时间略有延迟;分别为94分钟和87分钟。此外,从症状发作到就诊于急诊的延迟时间更长(症状发作至急诊到达超过12小时的情况在第一组中为16%,而在第二组中为4%)。两组之间主要的治疗方式均为直接经皮冠状动脉介入治疗(PPCI),且无显著差异(新冠疫情前时期为100%,新冠疫情时期为97%)。

结论

在新冠疫情期间,STEMI患者到医院就诊出现了一些延迟,但医疗护理实践没有显著变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37e2/7898991/c47604203a8c/HV-21-166-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37e2/7898991/5946e2ebe16f/HV-21-166-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37e2/7898991/f9a792078b24/HV-21-166-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37e2/7898991/c47604203a8c/HV-21-166-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37e2/7898991/5946e2ebe16f/HV-21-166-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37e2/7898991/f9a792078b24/HV-21-166-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37e2/7898991/c47604203a8c/HV-21-166-g003.jpg

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