Optimizing an Emergency Medical Dispatch System to Improve Prehospital Diagnosis and Treatment of Acute Coronary Syndrome: Nationwide Retrospective Study in China

• DOI: 10.2196/36929
• Publication Date: 2022-11-23T15:30:28Z
• Authors: Xuejie Dong; Fang Ding; Shuduo Zhou; Junxiong Ma; Na Li; Mailikezhati Maim...; Yawei Xu; Zhigang Guo; Shaobin Jia; Chunjie Li; Suxin Luo; Huiping Bian; Gesang Luobu; Zuyi Yuan; Hong Shi; Zhi-jie Zheng; Yinzi Jin; Yong Huo
• Keywords: Retrospective cohort study; Emergency Medical Services; China; Computer applications to medicine. Medical informatics; R858-859.7; Medical emergency; Logistic regression; 03 medical and health sciences; 0302 clinical medicine; Propensity score matching; Health Sciences; Humans; Acute Coronary Syndrome; Internal medicine; Retrospective Studies; Emergency medical services; Psychiatry; Original Paper; Emergency department; Management of Cardiac Arrest and Resuscitation; Emergency Medical Dispatch; Management of Acute Myocardial Infarction; 3. Good health; Myocardial infarction; Emergency Department Crowding; Emergency Medicine; Medicine; Emergency medicine; Acute coronary syndrome; Public aspects of medicine; RA1-1270; Cardiology and Cardiovascular Medicine

Background Acute coronary syndrome (ACS) is the most time-sensitive acute cardiac event that requires rapid dispatching and response. The medical priority dispatch system (MPDS), one of extensively used types emergency systems, hypothesized to provide better-quality prehospital treatment. However, few studies have revealed impact MPDS use on process ACS care. Objective This study aimed investigate whether was associated with higher diagnosis accuracy shorter delay for patients transferred by an service (EMS), using a national database in China. Methods retrospective analysis based integrated China’s hospital registry. From January 1, 2016, December 31, 2020, EMS-treated cases were divided into before after groups accordance launch time at each EMS center. primary outcomes included consistency between admission discharge, delay. Multivariable logistic regression propensity score–matching performed compare 2 total subtypes. Results A 9806 (3561 6245 MPDS) treated 43 centers included. overall group (Cohen κ=0.918, P<.001) than κ=0.889, P<.001). After MPDS, call-to-EMS arrival shortened matched (20.0 vs 16.0 min, P<.001; adjusted difference: –1.67, 95% CI –2.33 –1.02; subtype ST-elevation myocardial infarction (adjusted –3.81, –4.63 –2.98, P<.001), while arrival-to-door 20.0 P=.31) not significantly different all Conclusions optimized China increased reduced among ACS. An should be designed specifically fit modes regional basis.