Prehospital delay in patients presenting with acute ST-elevation myocardial infarction

Eur J Emerg Med. 2011 Oct;18(5):268-71. doi: 10.1097/MEJ.0b013e32834491d3.

Abstract

To characterize prehospital delays in patients presenting with acute ST-elevation myocardial infarction to the emergency department of a tertiary hospital in Asia. A retrospective review of 273 patients with diagnosis of ST-elevation myocardial infarction; symptom to door (S2D) time was described in two ways, time from first onset of symptoms; and time from the onset of the worst episode to presentation at emergency department. The median first onset S2D time was 173 min (interquartile range 80-350 min); and median worst episode S2D time was 131 min (interquartile range 70-261 min). Patients with prehospital delay tended to use their own transport compared with the no delay group (P=0.026, 95% confidence interval=0.02-0.24). There was no difference in S2D times for typical compared with atypical symptoms. A large proportion of patients experienced delay in seeking medical care after the onset of acute coronary symptoms. Self-transport was associated with delay.

MeSH terms

  • Confidence Intervals
  • Delayed Diagnosis / statistics & numerical data*
  • Emergency Medical Services / statistics & numerical data*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / pathology
  • Retrospective Studies
  • Singapore
  • Time Factors
  • Transportation of Patients