Impact of Prehospital 12-Lead Electrocardiography and Destination Hospital Notification on Mortality in Patients With Chest Pain - A Systematic Review.
Impact of Prehospital 12-Lead Electrocardiography and Destination Hospital Notification on Mortality in Patients With Chest Pain - A Systematic Review.
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DOI：
10.1253/circrep.cr-22-0003
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发表时间：
2022-05-10
期刊：
影响因子：
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通讯作者：
Nonogi, Hiroshi
中科院分区：
文献类型：
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作者：
Nakashima, Takahiro;Hashiba, Katsutaka;Kikuchi, Migaku;Yamaguchi, Junichi;Kojima, Sunao;Hanada, Hiroyuki;Mano, Toshiaki;Yamamoto, Takeshi;Tanaka, Akihito;Matsuo, Kunihiro;Nakayama, Naoki;Nomura, Osamu;Matoba, Tetsuya;Tahara, Yoshio;Nonogi, Hiroshi
背景：为了实现 ST 段抬高型心肌梗死 (STEMI) 的早期再灌注治疗，需要正确、及时地转运患者并激活导管实验室。我们调查了 STEMI 患者院前 12 导联心电图 (ECG) 采集和目的地医院通知的效果。方法和结果：这是对观察性研究的系统回顾。我们检索了PubMed数据库从建库到2020年3月的时间。两位审稿人独立进行文献筛选。关键结果是短期死亡率。重要的结果是门到气球 (D2B) 时间。我们使用 GRADE 方法来评估证据的确定性。对于关键结果，荟萃分析中纳入了涉及 29,365 名患者的 14 项研究。院前 12 导联心电图采集和目的地医院通知组的短期死亡率显着低于对照组（比值比 0.72；95% 置信区间 [CI] 0.61–0.85；P<0.0001）。对于重要结果，荟萃分析中纳入了涉及 2,947 名患者的 10 项研究。院前 12 导联心电图采集和目的地医院通知组的 D2B 时间明显短于对照组（平均差 -26.24；95% CI -33.46，-19.02；P<0.0001）。结论：对于院外疑似 STEMI 患者，院前 12 导联心电图采集和目的地医院通知与未采集心电图或未通知患者相比，短期死亡率较低，D2B 时间较短。
Background: To achieve early reperfusion therapy for ST-elevation myocardial infarction (STEMI), proper and prompt patient transportation and activation of the catheterization laboratory are required. We investigated the efficacy of prehospital 12-lead electrocardiogram (ECG) acquisition and destination hospital notification in patients with STEMI. Methods and Results: This is a systematic review of observational studies. We searched the PubMed database from inception to March 2020. Two reviewers independently performed literature selection. The critical outcome was short-term mortality. The important outcome was door-to-balloon (D2B) time. We used the GRADE approach to assess the certainty of the evidence. For the critical outcome, 14 studies with 29,365 patients were included in the meta-analysis. Short-term mortality was significantly lower in the group with prehospital 12-lead ECG acquisition and destination hospital notification than in the control group (odds ratio 0.72; 95% confidence interval [CI] 0.61–0.85; P<0.0001). For the important outcome, 10 studies with 2,947 patients were included in the meta-analysis. D2B time was significantly shorter in the group with prehospital 12-lead ECG acquisition and destination hospital notification than in the control group (mean difference −26.24; 95% CI −33.46, −19.02; P<0.0001). Conclusions: Prehospital 12-lead ECG acquisition and destination hospital notification is associated with lower short-term mortality and shorter D2B time than no ECG acquisition or no notification among patients with suspected STEMI outside of a hospital.