对沙特阿拉伯一家大型三级中心急诊科收治的非ST段抬高型急性冠状动脉综合征进行回顾性研究。
Retrospective review of non-ST segment elevation acute coronary syndrome presenting to the emergency department of a major tertiary center in Saudi Arabia.
作者信息
Qureshi Muhammad Nauman, Ahmed Eman Nayaz, Ahmed Khaled Abdulrahman, Bashtawi Eyad
机构信息
From the Department of Emergency Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
From the College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
出版信息
Ann Saudi Med. 2024 Jan-Feb;44(1):1-10. doi: 10.5144/0256-4947.2024.1. Epub 2024 Feb 1.
BACKGROUND
Acute coronary syndrome (ACS) comprises a spectrum of diseases ranging from unstable angina (UA), non-ST elevation myocardial infarction (non-STEMI) and ST elevation myocardial infarction (STEMI). Treatment of ACS without STEMI (NSTEMI-ACS) can vary, depending on the severity of presentation and multiple other factors.
OBJECTIVE
Analyze the NSTEMI-ACS patients in our institution.
DESIGN
Retrospective observational.
SETTING
A tertiary care institution with accredited chest pain center.
PATIENTS AND METHODS
The travel time from ED booking to the final disposition for patients presenting with chest pain was retrieved over a period of 6 months. The duration of each phase of management was measured with a view to identify the factors that influence their management and time from the ED to their final destination. The data was analyzed using descriptive statistics.
MAIN OUTCOME MEASURES
Travel time from ED to final destination.
SAMPLE SIZE
300 patients.
RESULTS
The majority of patients were males (64%) between 61 and 80 years of age (45%). The median disposition time (from ED booking to admission order by the cardiology team) was 5 hours and 19 minutes. Cardiology admissions took 10 hours and 20 minutes from ED booking to the inpatient bed. UA was diagnosed in 153 (51%) patients and non-STEMI in 52 (17%). Coronary catheterization was required in 79 (26%) patients, 24 (8%) had coronary artery bypass grafting (CABG) and 8 (3%) had both catheterization and CABG.
CONCLUSION
The time from ED booking to final destination for NSTEMI-ACS patients is delayed due to multiple factors, which caused significant delays in overall management. Additional interventional steps can help improve the travel times, diagnosis, management and disposition of these patients.
LIMITATIONS
Single center study done in a tertiary care center so the results from this study may not be extrapolated to other centers.
背景
急性冠状动脉综合征（ACS）包括一系列疾病，从不稳定型心绞痛（UA）、非ST段抬高型心肌梗死（non-STEMI）到ST段抬高型心肌梗死（STEMI）。非ST段抬高型急性冠状动脉综合征（NSTEMI-ACS）的治疗方法可能因病情严重程度和其他多种因素而异。
目的
分析我院的NSTEMI-ACS患者。
设计
回顾性观察研究。
地点
一家拥有经认可的胸痛中心的三级医疗机构。
患者和方法
收集6个月内胸痛患者从急诊科挂号到最终处置的就诊时间。测量管理各阶段的时长，以确定影响其管理以及从急诊科到最终目的地时间的因素。使用描述性统计方法分析数据。
主要观察指标
从急诊科到最终目的地的就诊时间。
样本量
300例患者。
结果
大多数患者为男性（64%），年龄在61至80岁之间（45%）。中位处置时间（从急诊科挂号到心脏病学团队下达入院医嘱）为5小时19分钟。从急诊科挂号到入住病房，心脏病学住院患者耗时10小时20分钟。153例（51%）患者被诊断为UA，52例（17%）为非STEMI。79例（26%）患者需要进行冠状动脉造影，24例（8%）接受了冠状动脉旁路移植术（CABG），8例（3%）同时进行了造影和CABG。
结论
由于多种因素，NSTEMI-ACS患者从急诊科挂号到最终目的地的时间有所延迟，这导致整体管理出现显著延误。额外的干预措施有助于缩短这些患者的就诊时间、改善诊断、管理和处置情况。
局限性
本研究在一家三级医疗机构进行，为单中心研究，因此本研究结果可能无法外推至其他中心。
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