Ya Guang Peng1, Jing Jing Feng2, Lu Fen Guo3, Nan Li4, Wen Heng Liu1, Guo Ju Li5, Guang Hao1, Xiao Lin Zu3. 1. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, People's Republic of China. 2. Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. 3. Emergency Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, People's Republic of China. 4. Emergency Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, People's Republic of China. Electronic address: anzhenlinan@163.com. 5. Wei Fang Medical University, Shandong, People's Republic of China.
Abstract
BACKGROUND: Prehospital delay is the most critical factor to prognosis of ST-elevation myocardial infarction (STEMI). Few study had examined a series of predictors of prehospital delay by multivariate analysis of sociodemographic and clinical characteristics, onset features, and symptom condition of STEMI in China. METHODS: A total of 1088 hospitalized STEMI participants were screened to collect sociodemographic data, medical history information, and symptom onset status from clinical medical records. Factors associated with prehospital delay were examined using bivariate and multivariate analysis method. RESULTS: The median prehospital delay time (PDT) was 130 minutes in STEMI participants. Multivariate regression models examining 8 predictors were associated with prehospital delay, including senior high school or above educational level, myocardial infarction (MI) history, vertigo onset symptom, ambulance transportation, onset in daytime (6:00-18:00), onset at home, anterior wall MI, and posterior wall MI. Mortality in PDT more than 120 minutes group was 5.5%, whereas it was 4.3% in PDT 120 minutes of less group without significant statistically difference (P > .05). CONCLUSIONS: Multivariate analysis results found that symptom onset-related variables strongly influenced PDT. Onset-related status of STEMI needed to be combined into interventions of participants, and more emergency education should be recommended to both participants and their relatives. Most importantly, more efforts should be taken to educate the public about the symptoms and signs to increase the recognition of STEMI.
BACKGROUND: Prehospital delay is the most critical factor to prognosis of ST-elevation myocardial infarction (STEMI). Few study had examined a series of predictors of prehospital delay by multivariate analysis of sociodemographic and clinical characteristics, onset features, and symptom condition of STEMI in China. METHODS: A total of 1088 hospitalized STEMI participants were screened to collect sociodemographic data, medical history information, and symptom onset status from clinical medical records. Factors associated with prehospital delay were examined using bivariate and multivariate analysis method. RESULTS: The median prehospital delay time (PDT) was 130 minutes in STEMI participants. Multivariate regression models examining 8 predictors were associated with prehospital delay, including senior high school or above educational level, myocardial infarction (MI) history, vertigo onset symptom, ambulance transportation, onset in daytime (6:00-18:00), onset at home, anterior wall MI, and posterior wall MI. Mortality in PDT more than 120 minutes group was 5.5%, whereas it was 4.3% in PDT 120 minutes of less group without significant statistically difference (P > .05). CONCLUSIONS: Multivariate analysis results found that symptom onset-related variables strongly influenced PDT. Onset-related status of STEMI needed to be combined into interventions of participants, and more emergency education should be recommended to both participants and their relatives. Most importantly, more efforts should be taken to educate the public about the symptoms and signs to increase the recognition of STEMI.
Authors: Hee Sook Kim; Kun Sei Lee; Sang Jun Eun; Si Wan Choi; Dae Hyeok Kim; Tae Ho Park; Kyeong Ho Yun; Dong Heon Yang; Seok Jae Hwang; Ki Soo Park; Rock Bum Kim Journal: Yonsei Med J Date: 2017-07 Impact factor: 2.759
Authors: Sofia Sederholm Lawesson; Rose-Marie Isaksson; Maria Ericsson; Karin Ängerud; Ingela Thylén Journal: BMJ Open Date: 2018-05-03 Impact factor: 2.692