Song So Ra, Kim Ki Hong, Park Jeong Ho, Song Kyoung Jun, Shin Sang Do
Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea.
Clin Exp Emerg Med. 2022 Dec;9(4):323-332. doi: 10.15441/ceem.22.330. Epub 2022 Sep 16.
This study aimed to evaluate the association between prehospital recognition of acute myocardial infarction (AMI) and length of stay (LOS) in the emergency department (ED) of emergency medical service (EMS)-transported AMI patients.
A multicenter retrospective observational study was conducted using prehospital and hospital data from three tertiary emergency departments. Patients diagnosed with AMI between January 2015 and December 2018 were enrolled. Study groups were categorized according to prehospital recognition and prehospital 12-lead electrocardiography (ECG) into three groups based on an EMS cardiovascular registry: group A, no prehospital recognition (reference group); group B, prehospital recognition without 12-lead ECG; and group C, prehospital recognition with 12-lead ECG. The primary outcome was an ED LOS of less than 4 hours.
Among 1,237 study participants, 722 (58.4%) were in group A, 325 (26.3%) were in group B, and 190 (15.4%) were in group C. Multivariable logistic regression showed that groups B and C had a higher likelihood of a short ED LOS (adjusted odds ratio [95% confidence interval]: group B, 1.64 [1.21-2.22] and group C, 1.88 [1.30-2.71]) than group A. There was no significant difference in ED LOS according to whether prehospital 12-lead ECG was conducted.
Prehospital recognition of AMI by EMS personnel, with or without 12-lead ECG, was associated with a short ED LOS.
本研究旨在评估急救医疗服务（EMS）转运的急性心肌梗死（AMI）患者在急诊科（ED）的院前急性心肌梗死识别与住院时间（LOS）之间的关联。
利用来自三个三级急诊科的院前和医院数据进行了一项多中心回顾性观察研究。纳入了2015年1月至2018年12月期间诊断为AMI的患者。根据EMS心血管登记系统，将研究组根据院前识别和院前12导联心电图（ECG）分为三组：A组，无院前识别（参照组）；B组，有院前识别但无12导联ECG；C组，有院前识别且有12导联ECG。主要结局是急诊住院时间少于4小时。
在1237名研究参与者中，722名（58.4%）在A组，325名（26.3%）在B组，190名（15.4%）在C组。多变量逻辑回归显示，B组和C组急诊住院时间较短的可能性高于A组（调整后的优势比[95%置信区间]：B组，1.64[1.21 - 2.22]；C组，1.88[1.30 - 2.71]）。根据是否进行院前12导联ECG，急诊住院时间无显著差异。
EMS人员对AMI的院前识别，无论是否有12导联ECG，均与较短的急诊住院时间相关。
