Investigation on implementation status of thrombolytic therapy in STEMI type myocardial infarction in Chengdu area and influencing factors analysis
Objective To understand the awareness of the emergency physicians for thrombolytic thera-py recommended by ST-segment elevation myocardial infarction(STEMI)guidelines and implementation sit-uation,and to analyze the related influencing factors.Methods Relying on Chengdu Emergency Quality Con-trol Center,the questionnaires were distributed to the hospitals of expert group members and the hospitals of the medical union from April to July 2023 to investigate the awareness,implementation status and training status of the emergency doctors in Chengdu area on the STEMI thrombolytic therapy.The causes affecting thrombolysis decision-making were analyzed.Results A total of 137 hospitals participated in the survey.Whether the treatment system and type of chest pain,chest pain center,percutaneous coronary intervention(PCI)qualified hospitals or departments carrying out the training and hospital grade were correlated to whether STEMI patients were thrombolyzed within 12 h before transport(P＜0.05).Whether the PCI quali-fied hospital,chest pain center,chest pain treatment system and type,carrying training,hospital grade,geo-graphical location,transport duration,and thrombolytic indication understanding situation were not related to whether thrombolytic therapy was recommended for the duration from the first medical contact(FMC)to PCI(FMC-PCI)≥120 min(P＞0.05).The multivariate logistic regression analysis showed that whether the de-partment carrying out the training was an influential factor for whether thrombolytic therapy was carried out within 12 h before transport in STEMI onset(P＜0.05).The hospital grade was a influencing factor for whether thrombolysis in non-chest pain treatment system was carried before transport within 12 h of the onset of STEMI.The main reason for STEMI patients being directly transfered treatment without thrombolysis within 12 h of onset was because they knew that thrombolysis was needed but did not know how to do it(50.00％).The awareness rate of thrombolytic indication in non-main urban area was higher than that in main urban area(P＜0.05).The carrying out department training rate of PCI qualified hospitals was higher than that of non-PCI qualified hospitals(P＜0.05).The receiving superior hospital training rate also had difference among different hospital grades and geographical locations.Conclusion Conducting the thrombolysis training and enhancing the learning of treatment processes directly affect the emergency physicians'choice of reperfu-sion strategies for the patients with STEMI.Continuous promotion of the construction of chest pain center or chest pain treatment unit could further increase the early reperfusion rate of STEMI.
万方数据
维普
