急性脑梗死患者就诊时间延迟的影响因素分析

Factors Influencing Postponement of Arrival Time in Patients with Acute Cerebral Infarction

目的分析影响急性脑梗死患者就诊时间延迟的相关因素,从而寻找可能的解决办法。方法收集2016年7月至2017年6月就诊于中国医科大学附属盛京医院急诊科急性脑梗死患者资料,记录患者性别、年龄、主要症状、来院时间、来院方式、基础疾病及居住地点。根据患者是否4.5 h内到达医院分为2组,应用t检验或χ~2检验、多因素logistic回归分析影响患者就诊时间延迟的相关因素。结果纳入研究的156例急性脑梗死患者中,63例(40.4%)发病至就诊时间<4.5 h,93例(59.6%)>4.5 h。多因素logistic回归分析显示年龄大、应用急救医疗服务(EMS)来院、城市及本地居住为影响患者发病后4.5 h内就诊的独立影响因素(均P <0.05)。结论年龄大、应用EMS、城市及本地居住的急性脑梗死患者发病至就诊时间较短,因此应加强对中年及农村地区人群宣传教育,鼓励急性脑梗死患者应用EMS来院就诊,本地区就近就医,进而缩短患者来院时间,改善患者预后。

Objective To identify the factors influencing postponement of arrival time in patients with acute cerebral infarction,with the aim of finding a solution to this issue.Methods The information of patients presenting with acute cerebral infarction to the emergency department of Shengjing Hospital of China Medical University,from July 1,2016,to June 31,2017,was analyzed.Age,arrival time,and transport modality were included in the retrospective analysis.The patients were divided into two groups based on if the arrival time was more or less than 4.5 hours.The t test,χ^2 test,and logistic regression were used to analyze the factors influencing postponement of arrival time.Results Of the 156 patients with acute cerebral infarction,only 63 patients(40.4%)arrived at hospital within 4.5 hours,and the remaining 93 patients(59.6%)arrived in over 4.5 hours.Older age,emergency medical services usage,living in a city,and local residence were independent influencing factors of an arrival time of less than 4.5 hours(all P<0.05).Conclusion To reduce arrival times and improve disease prognosis,we should educate younger and rural populations and encourage patients to use emergency medical services and to seek an appropriate nearby hospital.