Key result
EMS transport for patients with ST-segment elevation myocardial infarction was associated with a significantly lower mortality rate compared to non-EMS transport (5.99% vs 8.62%, p<0.001).
Why the study?
EMS transport and primary care by EMTs and paramedics reduce mortality and disability in acute myocardial infarction, prompting a comparison of outcomes between EMS and non-EMS transport in STEMI patients in southern Iran.
Does EMS transport improve survival and clinical outcomes in patients with STEMI compared to non-EMS transport?
Cross-Sectional (n=2,244)
No
Does EMS transport improve survival and clinical outcomes in patients with STEMI compared to non-EMS transport?
EMS transport for STEMI patients is associated with significantly higher survival rates from out-of-hospital cardiac arrest compared to non-EMS transport.
Answers are grounded in this paper and cite their sources.
EMS transport linked to lower STEMI mortality; hypothesis-generating and should not yet alter practice or guidelines.
BACKGROUND: In the medical management of acute myocardial infarction, the transport of patients and primary care provided by emergency medical technicians (EMTs) and paramedics are effective in reducing the mortality and disabilities. Therefore, the present study aimed to compare the outcomes of emergency medical services (EMS) vs. non-EMS transport of patients with ST-segment elevation myocardial infarction (STEMI) in southern Iran. METHODS: This is an analytical, cross-sectional study. The study population consisted of the individuals registered in Fasa Registry on Acute Myocardial Infarction (FaRMI) in the south of Iran. 2244 patients with STEMI were included in the study. Statistical analyses were performed using Chi-Square test and independent t-test at a significance level of P < 0.05 in SPSS 22. RESULTS: Out of the 2244 patients with STEMI, 1552 (69.16%) were male and 672 patients (29.94%) were female. 934(41.62%) patients used EMS transport to the hospital, while 1310 (58.37%) patients used non-EMS transport to the hospital. A total of 169 patients with STEMI (7.26%) expired (out-of-hospital cardiac arrest); of them, 113 (66.86%) patients did not use EMS transport to the hospital. Successful cardiopulmonary resuscitation (CPR) was performed on 52 patients who used EMS transport. 27 patients also received an effective DC shock due to ventricular fibrillation (VF). Of the total number of patients, 49 had a stroke; among them, 37(75.51%) patients did not use EMS transport. CONCLUSION: In the present study, the death rate in patients with acute myocardial infarction who used EMS transport was lower than those who used non-EMS transport. The health system managers and policymakers in the healthcare systems are recommended to take the necessary measures to increase public health awareness and knowledge about the use of EMS and consequently reduce the death rate and complications of acute myocardial infarction.
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Najafi et al. (2022) conducted a cross-sectional in ST-segment elevation myocardial infarction (STEMI) (n=2,244). Emergency Medical Services (EMS) transport vs. Non-EMS transport was evaluated on Death (mortality) (p=<0.001). EMS transport for patients with ST-segment elevation myocardial infarction was associated with a significantly lower mortality rate compared to non-EMS transport (5.99% vs 8.62%, p<0.001).
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