Analysis of factors influencing the pre-hospital treatment time of patients with STEMI in regional diagnosis and treatment center

Objective To analyze the influencing factors of pre-hospital treatment time for patients with acute ST-segment elevation myocardial infarction(STEMI) in regional diagnosis and treatment center.Methods STEMI patients who were admitted to Chest Pain Center, Xuzhou Central Hospital between June 2019 and March 2020 were selected. Their decision-making time(time from onset to decision to admit) and time to seek treatment(time from decision to admit to arrival at Emergency Room, Xuzhou Central Hospital) were calculated. Their demographic information, the course of disease and the history of disease were compared between the groups with decision-making time >6 h and ≤6 h. Their admission information and medical institution were compared between the groups of patients with >3 h and ≤3 h to seek treatment. Multivariate Logistic regression analysis was performed.Results A total of 421 patients were included, including 271(64.4%) patients with >6 h decision-making time and 150(35.6%) patients with ≤6 h decision-making time. There were statistical differences in education level, monthly income, working status, night onset, place of onset, awareness of disease, distance to hospital and general practitioner(P<0.05). Night onset and distance to hospital were the independent influencing factors of decision-making time(P<0.05). There were 261(62.0%) patients with >3 h to seek treatment and 160 patients(38.0%) with ≤3 h to seek treatment. There were statistical differences in the route of admission, night onset, distance to hospital, and whether the first visit medical institution was a member of regional diagnosis and treatment center(P<0.05). Referral from primary hospitals, self-admission, night onset, long distance to seek treatment, and non-member of regional diagnosis and treatment center for first-visit were the independent influencing factor of time to seek treatment(P<0.05).Conclusions Night onset and long distance to seek treatment can extend the decision-making time of STEMI patients. Referral from primary hospitals, self-admission, night onset, long distance to seek treatment, and non-member of regional diagnosis and treatment center for first-visit can extend the time to seek treatment of STEMI patients. It is necessary to improve the awareness of patients and their family toward STEMI, making full use of the cooperation of regional diagnosis and treatment center, in order to enhance the treatment efficiency and prognosis of patients with STEMI.