Effects of using Prehospital Emergency Care by 119 Rescue Services on Outcome of ST-elevation Myocardial Infarction Patients

ABSTRACT

PURPOSE: This study was performed to evaluate the effects of prehospital emergency care use by 119 rescue services on the outcome of acute ST-elevation myocardial infarction (STEMI). METHODS: All patients who visited 23 hospital emergency departments and who were finally diagnosed with STEMI between January and December 2008 were enrolled. They were divided into two groups: use of 119 rescue service or non-use. The propensity score matching method was used considering factors known to be influential for the use of 119 rescue services (age, gender, educational status, chief complaints, cardiogenic shock, respiratory rate, heart rate). Hospital mortality was defined as patient death in the hospital following admission. The comparative odds ratio (OR) and confidence interval (CI) of mortality between the 119 use and non-use groups were determined. RESULTS: Of the 1,118 STEMI patient, no statistical differences were evident in gender and age. Patients who used the 119 rescue services displayed lower educational status and rare complaint of chest pain is rare (36.6% vs 63.4%). But syncope and cardiac arrest were more frequent in the 119 user group than non-user group (syncope: 84.6% vs 15.4%, respectively; cardiac arrest: 76.0% vs 24.0%, respectively). Propensity score matching system was performed and extracted 390 patients in each group. The extracted patients were not statistically different in demographic findings and influencing factors of 119 service use. Hospital mortality did not differ between the 119 user and non-user groups (OR=1.294, 95% CI:0.612-2.735). Increased hospital mortality of STEMI patients was correlated with increased age (OR=1.036, 95% CI:1.012-1.060), prehospital ECG monitoring (OR=2.601, 95% CI:1.011-6.693), and cardiogenic shock (OR=4.736, 95% CI:2.482-9.037). CONCLUSION: The use of prehospital mobile units did not influence on hospital mortality of acute ST-elevation myocardial infarction.