{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:15:14Z","timestamp":1783318514052,"version":"3.54.6"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute myocardial infarction (AMI) requires rapid emergency care; however, triage delays in high-volume emergency departments remain a persistent challenge. Evidence on the combination of emergency procedural pathways with graded zoning management in AMI care is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective quasi-experimental study used sequential pre-post enrollment and included 126 patients with AMI. Patients admitted during the routine-care phase (CG;\n                      <jats:italic>n<\/jats:italic>\n                      = 64) received routine emergency nursing care, and patients admitted after protocol implementation (IG;\n                      <jats:italic>n<\/jats:italic>\n                      = 62) received an emergency procedural pathway combined with graded zoning management. Because enrollment was non-randomized and non-concurrent, all effect estimates were interpreted as associations rather than causal effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In-hospital survival was higher in the IG (96.8%, 60\/62) than the CG [81.3%, 52\/64; risk difference 15.5%, 95% CI 4.7\u201326.4%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.008; adjusted odds ratio [aOR] 6.50, 95% CI 1.32\u201332.0,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.022]. First-aid time was shorter (67.30 \u00b1 3.90 vs. 75.70 \u00b1 4.50 min; mean difference \u22128.40, 95% CI \u22129.87 to \u22126.93;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), and hospital stay reduced (14.62 \u00b1 2.05 vs. 18.08 \u00b1 4.55 days; mean difference \u22123.46, 95% CI \u22124.69 to \u22122.23;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Standardized reperfusion intervals were also shorter in the IG (door-to-balloon time among primary-PCI patients 78.5 \u00b1 12.3 vs. 92.4 \u00b1 15.6 min; door-to-needle time among thrombolysis patients 32.5 \u00b1 6.8 vs. 41.2 \u00b1 8.9 min; both\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). The cohort was predominantly STEMI (83.9% IG, 82.8% CG), with comparable reperfusion-modality use between groups. MACE was lower (6.5% vs. 18.8%; aOR 0.30, 95% CI 0.09\u20130.97,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.045). Quality-of-life scores improved across all GQOL-74 domains (all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001); post-intervention SAS (31.70 \u00b1 6.85 vs. 38.05 \u00b1 7.24;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and SDS (34.10 \u00b1 3.20 vs. 36.28 \u00b1 3.18;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) were lower in the IG. Patient satisfaction was higher (87.1% vs. 65.6%; risk difference 21.5%, 95% CI 7.4% to 35.6%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this single-center quasi-experimental study, the emergency procedural pathway combined with graded zoning management was associated with higher in-hospital survival, shorter treatment-related time, fewer cardiovascular complications, and better discharge quality-of-life and satisfaction scores. The magnitude of the observed mortality difference should be interpreted cautiously because residual confounding from unmeasured AMI severity, reperfusion eligibility, and temporal changes cannot be excluded.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1841718","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:37:27Z","timestamp":1783316247000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergency procedural pathway combined with graded zoning management is associated with improved in-hospital survival and quality of life in patients with acute myocardial infarction"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaoyan","family":"Song","sequence":"first","affiliation":[{"name":"Department of Emergency, The Affiliated Suzhou Hospital of Anhui Medical University, Suzhou","place":["Anhui, 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