Emergency care of acute myocardial infarction and the great East Japan earthquake disaster.
Emergency care of acute myocardial infarction and the great East Japan earthquake disaster.
复制标题
急性心肌梗死及东日本大地震灾害的急救。
作者：
K. Hao;J. Takahashi;K. Ito;S. Miyata;Y. Sakata;T. Nihei;R. Tsuburaya;T. Shiroto;Yoshitaka Ito;Y. Matsumoto;M. Nakayama;S. Yasuda;H. Shimokawa
背景
虽然理论上急性心肌梗死(AMI)的急诊护理可以通过改善患者延误来改善，但这一概念仍有待证实。此外，大地震对急性心肌梗死患者急救的影响还有待阐明。日本东部大地震(2011年3月11日)使我们能够解决这些问题。
方法和结果
我们分析了宫城急性心肌梗死注册研究中2008年至2011年的数据(n=3,937)。与前三年相比，2011年住院死亡率显著降低(7.3%vs.10.5%，P<；0.05)。这一改善在地震后的前2个月尤其明显，与从发病到入院的时间更短(120min比240min，P<；0.001)和初次经皮冠状动脉介入治疗的成功率(86.8%比76.2%，P<；0.01)有关。重要的是，地震后早期入院的患者(≤发病3h起)显著增加(59.1%比47.0%，P<；0.05)，预后变好(7.9%比11.4%，P=0.02)，入院时心力衰竭的发生率(6.9%比16.2%，P=0.02)和高的直接经皮冠状动脉介入治疗成功率(89.1%比76.4%，P<；0.01)。
结论
与平时相比，日本东部大地震后急性心肌梗死的急救护理得到了改善，这是由于发病时间更早和直接经皮冠状动脉介入治疗的成功率更高所致(Circ J 2014；78：634-643)。
BACKGROUND
Although emergency care of acute myocardial infarction (AMI) could theoretically be improved through improved patient delay, this notion remains to be confirmed. Additionally, the influence of large earthquakes on the emergency care of AMI cases remains to be elucidated. The Great East Japan Earthquake (March 11, 2011) has enabled us to address these issues.
METHODS AND RESULTS
We analyzed the data from 2008 to 2011 (n=3,937) in the Miyagi AMI Registry Study. In-hospital mortality was significantly lower in 2011 as compared with the previous 3 years (7.3% vs. 10.5%, P<0.05). This improvement was noted especially during the first 2 months after the Earthquake, associated with shorter elapsing time from onset to admission (120 vs. 240min, P<0.001) and higher performance rate of primary percutaneous coronary intervention (PCI) (86.8% vs. 76.2%, P<0.01). Importantly, after the Earthquake, patients with early admission (≤3h from onset) was significantly increased (59.1% vs. 47.0%, P<0.05) and their prognosis became better (7.9% vs. 11.4%, P=0.02), associated with a lower prevalence of heart failure on admission (6.9% vs. 16.2%, P=0.02) and higher performance rate of primary PCI (89.1% vs. 76.4%, P<0.01).
CONCLUSIONS
Emergency care of AMI improved soon after the Great East Japan Earthquake compared with ordinary times by the contribution of earlier admission from onset and higher performance rate of primary PCI. (Circ J 2014; 78: 634-643).
影响因子：
120.7
作者：
Luepker, RV;Raczynski, JM;Simons-Morton, DG
通讯作者：
Simons-Morton, DG
影响因子：
5.9
作者：
McManus, David D.;Gore, Joel;Yarzebski, Jorge;Spencer, Frederick;Lessard, Darleen;Goldberg, Robert J.
通讯作者：
Goldberg, Robert J.