| Objective By investigating the door-to-balloon time situation in acute ST-segment elevation myocardial infarction(STEMI) patients to identify risk factors of delay and possibilities for improvement.Method Through the electronic case file system,we collected patients' information that was presented with STEMI and under primary percutaneous coronary intervention(PCI) from January 2005 to December 2007.Related factors were analyzed by multivariate linear regression analysis and logistic regression to determine independent risk factors which led to delay.Results A total of 93 patients with STEMI were enrolled in this study with the median door-to-balloon time 180 min(interquartile range 110-270 min),of which 17(18.3%) patients match the recommended 90min from Guidelines,with the median door-to-balloon time 70min(60-90min);61(65.6%)patients were significantly delayed(the door-to-balloon time>120 min),the median door-to-balloon time was 200min(180-360 min).The median door-to-balloon time was 140min(90-180min) for patients presented directly,180min(132.5-360min) for patients transferred in from outside hospitals,210min(150-360min) for patients presented out of working: time,110min(95-180min) for patients presented during routine working time.The risk factors that associated with significantly delay were transferred from other hospitals(P=0.043) and presented out of working time(P=0.003).In addition,compare with 2005,the median door-to-balloon time was decreased significantly in patients presented in 2006 and 2007(210min vs 180min,P=0.005;210min vs 140min,P=0.003)Conclusion Although the was improvement in the door-to-balloon time in recently years,it still far beyond the 90min standard that the guidelines recommended. The strongest predictors of delay were hospital transfer and non-working time presentation.,which should be addressed and steps should be taken to further improve.
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