| ObjectiveTo analyze the influence of the improvement of the construction of chest pain center in our hospital on the critical time node,treatment process and clinical outcome of emergency PCI for patients with acute coronary syndrome.MethodsPatients diagnosed with ACS and receiving the Primary percutaneous coronary intervention(pPCI)were retrospectively analyzed during the construction and trial operation of the standardized chest pain center in our hospital in accordance with the certification standards of the Chinese chest pain center and continuous improvement from March 2018 to February 2019.84 ST-elevation acute coronary infarction(STEMI)patients and 21 patients with very-high-risk non-ST elevation myocardial infarction(NSTEMI)admitted to the chest pain center during the trial period from March 2019 to August 2019 were selected as the control group.The observation group was 102 STEMI and 25 very-high-risk NSTEMI patients treated during the official operation period of the chest pain center trial from September 2019 to February 2020.The generalclinical data,clinical Symptom oneset to first medical contact(S2FMC),catheter room activation time,and Door to ball time were compared between the two groups.D2B)differences in critical time nodes,treatment history,in-hospital complication rate,left ventricular ejection fraction,hospitalization expenses and outcomes.Results1.Before and after improvement,FMC2 ECG time was 6.34±1.53 min compared with 4.19±0.29 min,P=0.011,and ECG diagnosis time was7.34±0.53 min compared with 3.76±0.43 min,P < 0.001.The activation time of the catheter room was 17.41±0.92 min,compared with12.18±0.48 min,P=0.003.The cTnI report time was 21.52±0.76 minutes,compared with 15.18±0.33 minutes,P=0.003.The goal-ball time was65.18±7.72 minutes compared with 46.22±2.66 minutes,P=0.014.The completion time from FMC to PCI was 106.49±3.87 minutes,compared with 88.50±2.11 minutes,with a decrease of P=0.002,all of which were statistically significant.The total ischemic time was 390.70±75.01 min compared to 363.77±70.55 min(P > 0.05),and the difference was not statistically significant(7.53±0.28).2.The proportion of remote ECG sending in the trial group and the formal operation group was 33/84 =39.2% and 54/102 =52.9%,P=0.001.The proportion of emergency department and CCU directintervention room was increased by 24/84 =28.6% compared with 42/102=40.4%,P=0.013,and the difference was statistically significant.3.There was no significant difference between the trial operation group and the formal operation group in the incidence of major heart and blood catheter malpractice in the hospital period(5/84=6.0% vs.7/102=5.8%,P > 0.05 and the hospital mortality rate(2/84=2.4% vs.2/102=2.0%,P >0.05).The hospitalization expenses of the trial operation group and the formal operation group were 34870±2454 to 28830±3226 yuan,P=0.031,and the difference was statistically significant.ConclusionThe construction of a chest pain center can effectively reduce the time window for diagnosis and treatment of chest pain patients,improve the short-term prognosis of patients with emergency PCI,and reduce hospitalization costs. |
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