급성 관상동맥 증후군 환자의 응급실 내원 수단에 따른 중증도 분류와 치료시간 비교
Triage level and treatment time according to mode of arrival to emergency department in patients with acute coronary syndrome
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: The purpose of this study was to determine whether, in patients with acute coronary syndrome (ACS), according to the mode of arrival affect the emergency medical process. Methods: The participants of this study were 118 adult patients (46 patients admitted by emergency medical services (EMS), 48 walk-in patients, and 24 transferred from other hospitals) admitted to the emergency departments at one regional-level medical center who underwent coronary angiography between January 1, 2016 and December 31, 2017. To compare treatment courses, the median values of the following variables were compared among groups: symptom to door time; door to triage time; and door to ECG time. All data were analyzed using SPSS program. Results: Based on the initial assessment at triage, there was a significantly greater proportion of Korean Triage and Acuity Stage (KTAS) Level 1 or 2 among patients admitted by EMS than among walk-in patients. All three analyzed variables were lower in patients admitted by EMS than in the other two groups. Conclusion: Our results show that ACS patients who accessed EMS reached the emergency center faster after symptom onset, received initial triage assessment at earlier stages, and underwent sooner important examinations (i.e., the 12-lead ECG).
Abstract
Purpose: The purpose of this study was to determine whether, in patients with acute coronary syndrome (ACS), according to the mode of arrival affect the emergency medical process. Methods: The participants of this study were 118 adult patients (46 patients admitted by emergency medical services (EMS), 48 walk-in patients, and 24 transferred from other hospitals) admitted to the emergency departments at one regional-level medical center who underwent coronary angiography between January 1, 2016 and December 31, 2017. To compare treatment courses, the median values of the following variables were compared among groups: symptom to door time; door to triage time; and door to ECG time. All data were analyzed using SPSS program. Results: Based on the initial assessment at triage, there was a significantly greater proportion of Korean Triage and Acuity Stage (KTAS) Level 1 or 2 among patients admitted by EMS than among walk-in patients. All three analyzed variables were lower in patients admitted by EMS than in the other two groups. Conclusion: Our results show that ACS patients who accessed EMS reached the emergency center faster after symptom onset, received initial triage assessment at earlier stages, and underwent sooner important examinations (i.e., the 12-lead ECG).
참고문헌 (28)
- Mozaffarian D, "Executive summary: heart disease and stroke statistics —2016 update: a report from the American Heart Association", Circulation, 133(4), pp.447~454 (2016)[DOI]
- "Korea Centers For Disease Control &prevention"[URL]
- "Cause of death statistics"[URL]
- "2012 ESC Guidelines on acute myocardial infarction (STEMI)", Eur Heart J, 33(20), pp.2501~2502 (2012)[DOI]
- De Luca G, "Symptom-onset-to-balloon time and mortality in patients with acute myocardial infarction treated by primary angioplasty", J Am Coll Cardiol, 42(6), pp.991~997 (2003)[DOI]
- Bates ER, "Time to treatment in patients with STEMI", N Engl J Med, 369(10), pp.889~892 (2013)[DOI]
- Mol KA, "Delays in the treatment of patients with acute coronary syndrome : Focus on pre-hospital delays and non-ST-elevated myocardial infarction", Int J Cardiol, 221, pp.1061~1066 (2016)[DOI]
- Pereira H, "The stent for life initiative : factors predicting system delay in patients with ST-segment elevation myocardial infarction", Rev Port Cardiol, 37(8), pp.681~690 (2018)[DOI]
- Mirzaei S, "The association between symptom onset characteristics and prehospital delay in women and men with acute coronary syndrome", Eur J Cardiovasc Nurs, 19(2), pp.142~154 (2020)[DOI]
- Menees DS, "Door-toballoon time and mortality among patients undergoing primary PCI", N Engl J Med, 369(10), pp.901~909 (2013)[DOI]
- Deutsch SB, "Decreased door to balloon time : better outcome for the patient?", World J Cardiovasc Dis, 5(03), pp.49~52 (2015)[DOI]
- Ibanez B, "Integrating the results of the CULPRIT-SHOCK trial in the 2017 ESC ST-elevation myocardial infarction guidelines : viewpoint of the task force", Eur Heart J, 39(48), pp.4239~4242 (2018)[DOI]
- Kim JH, "A study on the scope of practice for emergency medical technician in the law regarding the emergency care", Doctor, pp.2019
- Welsh RC, "Prehospital management of acute ST-elevation myocardial infarction : a time for reappraisal in North America", Am Heart J, 145(1), pp.1~8 (2003)[DOI]
- Choi SW, "Effect of emergency medical service use and inter-hospital transfer on time to percutaneous coronary intervention in patients with ST elevation myocardial infarction : a multicenter observational study", Prehosp Emerg Care, 20(1), pp.66~75 (2016)[DOI]
- "National Emergency Medial Center" (2017)[URL]
- Canto JG, "Use of emergency medical services in acute myocardial infarction and subsequent quality of care : observations from the National Registry of Myocardial Infarction 2", Circulation, 106(24), pp.3018~3023 (2002)[DOI]
- Goldberg RJ, "Prehospital transport of patients with acute myocardial infarction : a community-wide perspective", Heart Lung, 37(4), pp.266~274 (2008)[DOI]
- Goodacre SW, "Clinical predictors of acute coronary syndromes in patients with undifferentiated chest pain", QJM : An International Journal of Medicine, 96(12), pp.893~898 (2003)[DOI]
- 이세종, "병원전 119 이용이 ST분절상승 급성심근경색 환자의 치료 결과에 미치는 효과", 대한응급의학회지, 22(1), pp.16~21 (2011), 대한응급의학회
- Cervellin G, "Multicenter survey on emergency nurses’ perception of numerical rating scale reliability at triage time in adult emergency department patients", Emergency Care Journal, 14(3), pp.111~115 (2018)[DOI]
- 박준범, "한국형 응급환자 분류도구의 이해", 대한응급의학회지, 28(6), pp.547~551 (2017), 대한응급의학회
- 하상욱, "응급실에서 중증도가 낮게 평가된 undertriage 환자들의 임상적 특징과 나쁜 예후 발생: 일개 대학병원 관찰연구", 대한응급의학회지, 22(6), pp.701~708 (2011), 대한응급의학회
- Tsai KC, "Alternative tool for triaging patients with possible acute coronary symptoms before admission to a chest pain unit", Am J Emerg Med, 36(7), pp.1222~1230 (2018)[DOI]
- Gerhardt W, "Troponin-T and CK MB (mass) in early diagnosis of ischemic myocardial injury. The Helsingborg study, 1992", Clin Biochem, 26(4), pp.231~240 (1993)[DOI]
- McNamara RL, "Effect of door-to-balloon time on mortality in patients with ST-segment elevation myocardial infarction", J Am Coll Cardio, 47(11), pp.2180~2186 (2006)[DOI]
- Lambrew CT, "Factors influencing the time to thrombolysis in acute myocardial infarction", Arch Intern Med, 157(22), pp.2577~2582 (1997)[DOI]
- Neumar RW, "Part 1: executive summary: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care", Circulation, 132(18-2), pp.S315~S367 (2015)[DOI]
