Patients with chest pain calling 9-1-1 or self-transporting to reach definitive care: Which mode is quicker?
Patients with chest pain calling 9-1-1 or self-transporting to reach definitive care: Which mode is quicker?
复制标题
DOI：
10.1016/s0002-8703(03)00510-6
复制
发表时间：
2004-01-01
影响因子：
4.8
通讯作者：
Cornell, C
中科院分区：
文献类型：
--
作者：
Hutchings, CB;Mann, NC;Cornell, C
目的：我们研究了运输时间的差异，胸痛患者谁使用私人交通工具相比，患者谁使用紧急医疗服务（EMS），以达到明确的medicalcare.Methods这是一项回顾性队列研究的数据使用的快速早期行动冠状动脉治疗（REACT）试验在20个美国城市进行。通过使用（1）决定寻求护理到初步护理，（急诊科[艾德]到达与EMS到达现场[n = 1209]）;（2）决定艾德到达（两组[n=2388]）;（3）一旦入住艾德，至溶栓治疗的时间（两组[n=309]）;（4）决定寻求溶栓治疗（n=276）。经过的旅行时间内邮政编码进行排名，并提交到一个嵌套的方差分析模型，以确定是否经过的时间是不同的运输models.Results之间的私人交通（35分钟）导致更快的艾德到达比使用EMS（39分钟，P = .0014）。然而，如果认为EMS治疗是初始护理，拨打9-1-1（6分钟）比使用私人交通工具前往艾德的患者（32分钟，P < .001）更快。当考虑到艾德的“门到针”时间时，与使用私人交通工具的患者相比，EMS运输导致溶栓给药所需的时间更短（分别为32和49分钟[P < .001]）或从决定寻求护理到给予溶栓治疗的时间（75 vs 92 min，分别，[P = 0.042]）.结论虽然私人交通导致更快的行程到艾德，更快的护理获得与使用EMS.
Objective We examined differences in transport times for patients with chest pain who used private transportation compared with patients who used emergency medical services (EMS) to reach definitive medical care.Methods This was a retrospective cohort study with data used from the Rapid Early Action for Coronary Treatment (REACT) trial conducted in 20 US cities. Elapsed time to care was examined through the use of (1) decision to seek care to initial care (emergency department [ED] arrival versus EMS arrival on scene [n = 1209]); (2) decision to ED arrival (for both groups [n=2388]); (3) time to thrombolytic therapy once admitted to the ED (for both groups [n=309]); and (4) decision to seek care to thrombolytic therapy (n=276). Elapsed travel times were ranked within Zip Codes and submitted to a nested analysis of variance model to determine if elapsed times were different between modes of transport.Results Private transportation (35 minutes) resulted in faster ED arrival than using EMS (39 minutes, P = .0014). However, if one considers EMS treatment to be initial care, calling 9-1-1 (6 minutes) resulted in much quicker care than patients using private transportation to the ED (32 minutes, P < .001). Transport by EMS resulted in a shorter elapsed time to thrombolytic administration compared with patients using private transportation when considering ED "door-to-needle" time (32 vs 49 minutes, respectively [P < .001]) or time from decision to seek care until administration of thrombolytic therapy (75 vs 92 minutes, respectively, [P = .042]).Conclusions Although private transportation results in a faster trip to the ED, quicker care is obtained with the use of EMS.