Effect of Prehospital Digital Electrocardiogram Transmission on Revascularization Delays and Mortality in ST-Elevation Myocardial Infarction Patients: Systematic Review and Meta-Analysis
Notice bibliographique
Résumé
BackgroundPre-hospital transmission of the 12-lead electrocardiogram (ECG) to the interventional cardiologist has become the standard of care in many ST-elevation myocardial infarction (STEMI) networks but has not been universally adopted. In this systematic review and meta-analysis, we assess the effect of pre-hospital digital ECG transmission in STEMI patients on door-to-device times, first medical contact-to-device times, and mortality.MethodsWe performed a systematic review of all English studies in MEDLINE, EMBASE and CENTRAL (from inception to July 24, 2023), comparing the effect of pre-hospital digital ECG transmission to no ECG transmission in STEMI patients. We performed a random-effects meta-analysis.ResultsWe included 17 observational studies totalling 4,306 patients. Door-to-device times were reduced by 33.3 minutes in patients with pre-hospital digital ECG transmission (95% confidence intervals (CI) -50.5, -16.2 minutes; p<0.001; I2 99%). First medical contact-to-device time was also reduced with pre-hospital digital ECG transmission (mean difference -24.7 minutes; 95% CI -37.1, -12.3 minutes; p<0.001; i2 96%). Pre-hospital digital ECG transmissions was associated with a 47% reduction in mortality compared to no pre-hospital digital ECG transmission (117/1,322 (8.9%) versus 181/1,322 (13.7%), odds ratio 0.53, 95% CI 0.40, 0.69; p < 0.001; I2 = 0%).ConclusionsPre-hospital ECG transmission in STEMI patients, coupled with a systems of care reduced door-to-device times, first medical contact-to-device times, and mortality. STEMI networks should consider these findings to advocate for pre-hospital ECG transmission within their systems of care. Pre-hospital transmission of the 12-lead electrocardiogram (ECG) to the interventional cardiologist has become the standard of care in many ST-elevation myocardial infarction (STEMI) networks but has not been universally adopted. In this systematic review and meta-analysis, we assess the effect of pre-hospital digital ECG transmission in STEMI patients on door-to-device times, first medical contact-to-device times, and mortality. We performed a systematic review of all English studies in MEDLINE, EMBASE and CENTRAL (from inception to July 24, 2023), comparing the effect of pre-hospital digital ECG transmission to no ECG transmission in STEMI patients. We performed a random-effects meta-analysis. We included 17 observational studies totalling 4,306 patients. Door-to-device times were reduced by 33.3 minutes in patients with pre-hospital digital ECG transmission (95% confidence intervals (CI) -50.5, -16.2 minutes; p<0.001; I2 99%). First medical contact-to-device time was also reduced with pre-hospital digital ECG transmission (mean difference -24.7 minutes; 95% CI -37.1, -12.3 minutes; p<0.001; i2 96%). Pre-hospital digital ECG transmissions was associated with a 47% reduction in mortality compared to no pre-hospital digital ECG transmission (117/1,322 (8.9%) versus 181/1,322 (13.7%), odds ratio 0.53, 95% CI 0.40, 0.69; p < 0.001; I2 = 0%). Pre-hospital ECG transmission in STEMI patients, coupled with a systems of care reduced door-to-device times, first medical contact-to-device times, and mortality. STEMI networks should consider these findings to advocate for pre-hospital ECG transmission within their systems of care.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,009 | 0,002 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».