ABSTRACT
Objective To explore the effects of target value management for quality control indexes in chest pain center on the efficiency and effectiveness of in-hospital treatment for STEMI patients.Methods The database of Chest Pain Center in General Hospital of Guangzhou Military Command was retrospectively analyzed.STEMI patients who visited our hospital from March 2011 to March 2018 were selected as the research subjects.During the review period,the target values of quality control indexes were adjusted 4 times.Before and after the 4 adjustment,the efficiency indexes of in-hospital treatment STEMI patients were compared,including the first medical contact to the first electrocardiogram (FMC2ECG) time,catheter lab activation time and Door-to-Balloon (D2B) time.Length of hospital stay,in-hospital mortality and hospitalization cost were compared as well.Results A total of 332 STEMI patients were included in the study.As the quality control target values became stricter,the median and the average value of FMC2ECG time,catheter lab activation time and D2B time showed a downward trend.Among these data,the D2B time decreased from 95 (74,134.5) min to 50 (44.5,71) min,and its differences were of the most significance.However,there is no significant difference in the hospitalization cost,length of hospital stay and in-hospital mortality of STEMI patients.Conclusions The target value management of quality control indexes can improve the in-hospital treatment efficiency for STEMI patients,but the improvements of treatment efficiency and effectiveness cannot be immediately revealed.It takes a certain amount of time and needs enough cases to reach a significant difference.
ABSTRACT
Objective To evaluate the influence of different clinic pathways on the time from first medical contact to balloon (FMC2B) and the time from door to balloon (D2B) for emergency patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention as well as the prognosis. Methods 183 consecutive patients were divided into emergency easy access group and normal access group. The two groups were compared in terms of the FMC2B time, D2B time and outcomes during hospitalization and follow-up. Results Compared with the normal access group, the FMC2B time in the emergency easy access group was significantly shorter (100.3 min vs. 145.6 min, P < 0.05) and so it was with the D2B time (77.1 min vs. 115.4 min, P<0.05). Meanwhile, in-hospital mortality was significantly lower (5.0%vs. 15.7%, P<0.05). The follow-ups showed the rates of re-hospitalization related to heart diseases, and the mortality rate of cardiovascular disease were significantly lower in the emergency easy access group. Conclusion The optimized emergency easy access could reduce the FMC2B time and D2B time and improve the prognosis of patients with STEMI.