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응급의료서비스 이용 유무에 따른 급성 심근경색증 환자의 1년간 주요 심뇌혈관사건 발생 비교
  • 작성일2021-02-23
  • 최종수정일2021-02-23
  • 담당부서연구기획과
  • 연락처043-719-8033

대한응급의학회지, 2020.31(2), 181-190, DOI: https://doi.org/


응급의료서비스 이용 유무에 따른 급성 심근경색증 환자의 1년간 주요 심뇌혈관사건 발생 비교

김수진, 이은숙; 정명호; 김민철; 심두선; 홍영준; 김주한; 안영근; 조명찬; 김종진; 김영조


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.
    Methods: 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 non- EMS 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.



  • 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
  • This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.


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