Objective:

To evaluate the association of an emergency procedural pathway combined with graded zoning management on in-hospital survival and quality of life among patients with acute myocardial infarction (AMI).

Approach:

• Study Design: Prospective quasi-experimental study with sequential pre-post enrollment.
• Participants: 126 patients with AMI; 64 in control group (CG) receiving routine care and 62 in intervention group (IG) receiving the new protocol.
• Data Collection: Comparison of in-hospital survival, treatment times, quality of life, and patient satisfaction between CG and IG.

Key Findings:

• In-hospital survival was higher in IG (96.8%) compared to CG (81.3%), p = 0.008.
• First-aid time was shorter in IG (67.30 min) than CG (75.70 min), p < 0.001.
• Hospital stay was reduced in IG (14.62 days) compared to CG (18.08 days), p < 0.001.
• Standardized reperfusion intervals were shorter in IG for both primary PCI and thrombolysis, p < 0.001.
• Major adverse cardiovascular events (MACE) were lower in IG (6.5%) than CG (18.8%), p = 0.045.
• Quality-of-life scores improved across all GQOL-74 domains in IG, p < 0.001.
• Patient satisfaction was higher in IG (87.1%) compared to CG (65.6%), p = 0.005.

Interpretation:

The emergency procedural pathway combined with graded zoning management was associated with improved in-hospital survival, reduced treatment times, fewer complications, and enhanced quality of life and patient satisfaction.

Limitations:

• Non-randomized and non-concurrent enrollment limits causal interpretations.
• Potential residual confounding from unmeasured AMI severity and reperfusion eligibility.

Conclusion:

The study indicates that the integrated approach may enhance outcomes for AMI patients, though caution is advised in interpreting the mortality differences.