The application of a mobile-phone based telemedicine of hierarchical medical system in patients with ST segment elevation myocardial infarction / 中华老年医学杂志

ABSTRACT

Objective To explore the effect of a mobile-phone based two-way referral system on the timing of myocardial reperfusion and on a prognosis of patients with ST segment elevation myocardial infarction(STEMI). Methods Patients with STEMI were divided into an intervention group whose first admission clinics were equipped with a telemedicine system at the first medical contact(FMC) ,and a control group without a telemedicine system at FMC. The rate of heart failure and cardiac death during hospitalization ,every time point of transporting process ,the value of left ventricular ejection fractions(LVEF)measured at 24 h ,and length of hospital stay were collected and compared. Results In comparison of intervention versus control group ,the timing of myocardial reperfusion at every time point was shorter ( P ＜ 0.05 ) ,the value of LVEF within 24 h was significantly lower[(46.8 ± 3.9)%]vs[(50.3 ± 5.1)%](t＝ 2.32 ,P＜ 0.05) ,the cardiac mortality was lower(4% vs 7%) ,without statistical significance(χ2＝0.19 ,P＝0.66) ,and the length of hospital stay were lower[(6.35 ± 3.68)d]vs[(8.64 ± 5.19)d]without statistical significance (t＝ 2.75 ,P＝0.01). Conclusions A mobile-phone based telemedicine can significantly shorten the time delay of myocardial reperfusion in patients with STEMI ,improve heart function in acute stage ,and reduce the length of hospital stay.