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Journal of The Korean Society of Emergency Medicine 2020;31(2): 181-190. |
| 응급의료서비스 이용 유무에 따른 급성 심근경색증 환자의 1년간 주요 심뇌혈관사건 발생 비교 |
김수진1,2
, 이은숙3, 정명호1,2
, 김민철1,2, 심두선1,2, 홍영준1,2, 김주한1,2, 안영근1,2, 조명찬4, 김종진5, 김영조6 |
1전남대학교병원 심장센터
2보건복지부 지정 심혈관 융합 연구센터
3전남대학교 간호대학
4충북대학교병원 심장내과
5경희대학교병원 심장내과
6영남대학교병원 심장내과 |
| Comparison of major cardiac and cerebrovascular events in patients with acute myocardial infarction according to the use of emergency medical service during one-year clinical follow-up |
| Su Jin Kim1,2
, Eun Sook Lee3, Myung Ho Jeong1,2
, Min Chul Kim1,2, Doo Sun Sim1,2, Young Joon Hong1,2, Ju Han Kim1,2, Youngkeun Ahn1,2, Myeong Chan Cho4, Chong Jin Kim5, Young Jo Kim6 |
1The Heart Center of Chonnam National University Hospital, Gwangju, Korea
2The Heart Research Center Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
3Department of Nursing, Chonnam National University, Gwangju, Korea
4Department of Cardiology, Chungbuk National University Hospital, Cheongju, Korea
5Department of Cardiology, Kyung Hee University Hospital, Seoul, Korea
6Department of Cardiology, Yeungnam University Hospital, Daegu, Korea |
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Received: November 21, 2018; Revised: January 26, 2019 Accepted: March 4, 2019. Published online: April 30, 2020. |
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| ABSTRACT |
Objective:
The emergency medical service (EMS) is expected to improve the prognosis of patients suffering from acute myocardial infarction (AMI). We investigated the impact of utilizing EMS on the clinical outcomes of AMI patients.
Method:
From November 2011 to November 2015, a total of 13,102 patients in the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) registry were enrolled. Patients were divided into two groups: the EMS group, first medical contact (FMC) with 119; the non-EMS group, the FMC at local hospitals that were not available for percutaneous coronary intervention. The authors analyzed the mortality and major adverse cardiac and cerebrovascular events during one-year of clinical follow-up.
Results:
A total of 8,863 patients were finally analyzed for this study, and a total of 1,999 patients (22.6%) utilized the EMS as FMC. The patients utilizing EMS were more frequently diagnosed with ST-segment elevation AMI. At presentation, the EMS group had a higher incidence of Killip class IV, and they had a shorter symptom-to-door time than nonEMS group. The patients utilizing EMS had higher incidence of peri-procedural complications and in-hospital mortality. The multivariate logistic regression analysis with backward elimination revealed that utilizing EMS is an independent factor for predicting lower one-year mortality.
Conclusion:
This study has demonstrated that the high-risk AMI patients can utilize the EMS in Korea. The EMS group has more favorable clinical outcome during one-year follow-up after discharge than the non-EMS group, whereas it had a higher rate of death during hospitalization compared with that of the non-EMS group. |
| Key words:
Emergency medical service; Myocardial infarction; Mortality |
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