Impact Of Different Arrivals To Hospital On Treatment Time Of Acute ST-Segment Elevation Myocardial Infarction (STEMI) Patients Under Chest Pain Center Mode

Objective: To investigate the impact of different arrivals to hospital on treatment time of acute ST-segment elevation myocardial infarction(STEMI)patients under chest pain center mode.Methods: Patients with STEMI who entered the chest pain center process and underwent emergency PCI from 2018 to 2021 in our hospital were retrospectively analyzed.The patients were divided into three groups including the group that arrival at the hospital by themselves(Self-driving group),the group that bypassing the emergency department(Bypassing group),and the group that non-bypassing emergency department(Non-bypassing group).Parameters including symptom onset to first medical contact(s-to-fmc),door to balloon(d-to-b)time,symptom onset to balloon(s-to-b)time,symptom onset to door(s-to-d)time,and first medical contact to balloon(fmc-to-b)time were recorded.Factors that affect these parameters were investigated.Results: 1.)d-to-b time of bypassing group was the shortest.The difference of d-to-b time between bypassing group and self-driving group,and between non-bypassing group and bypassing group was statistically significant(P’<0.017),and there was no significant difference between self-driving group and non-bypassing group(P>0.05);2.)s-to-fmc time of self-driving group was the longest.The difference of s-to-fmc time between self-driving group and bypassing group,and between self-driving group and non-bypassing group was statistically significant(P’<0.017),but there was no statistical significance between bypassing group and non-bypassing group(P>0.05).3.)s-to-b time of self-driving group was the shortest.And the difference between non-bypassing group and bypassing group,and between non-bypassing group and self-driving group was statistically significant(P’<0.017),and there was no significant difference between self-driving group and bypassing group(P>0.05)Binary logistic regression analysis recovered that initial admission in non-PCI hospital,symptom onset at night and transport time over 2 hours were the independent impact factors for prolonged symptom onset to balloon(s-to-b)time in STEMI patients.Initial admission in PCI hospital,influence of COVID-19 epidemic and symptom onset at night were the independent impact factors for prolonged symptom onset to first medical contact(s-to-fmc)time.Conclusion: Arriving nearest PCI hospital cath lab directly was the best way to reduce symptom onset to shorten ischemic time in STEMI patients under chest pain center mode.Patients that reach to the hospital union and then transport to PCI hospital is also effective means to shorten s-to-b time.Formulate the corresponding treatment countermeasures is necessary to minimize the adverse impact factors of COVID-19 epidemic in STEMI patients treatment.