Prehospital delay in myocardial infarction could be shortened by community education and by alerting emergency medical services in a more timely fashion
█ Original article
Dani Győző1, Jambrik Zoltán2, Márk László2
1Városi Kórház, Orosháza
2Békés Megyei Központi Kórház, Pándy Kálmán Tagkórháza, Gyula
Dr. Dani Győző, e-mail: firstname.lastname@example.org
Introduction: The magnitude of total ischemic time determines the outcome of patients with ST-segment elevation myocardial infarction (STEMI) and is highly dependent on the delay of the patients themselves.
Objective: To assess what factors influence patient decision making and the length of pre-hospital care in our own region.
Methods: We examined 145 patients with STEMI at the Invasive Cardiology Department of Békés County Central Hospital between 1 December 2015 and 31 December, 2016. We recorded the duration of pre-hospital and hospital treatment. We designed a questionnaire to assess the nature and strength of patient complaints related to seeking medical assistance, on-site care and former patient knowledge about myocardial infarction.
Results: The median delay time for patients was 100 (30–240) minutes, and the total ischemic time was 220 (126–421) minutes. The rate of patients turning directly to the National Ambulance Service for help was 34.5% in our region, while it was 54.8% according to the data Hungarian Myocardial Infarction Registry. If the primary care provider was the ambulance service, the total ischemic time was significantly shorter (166 [105–267] vs. 240 [150–490] minutes, p=0.001). The nature and severity of patients’complaints influenced the time to seek health care.
Conclusions: Pre–hospital delay in ST elevation myocardial infarction is shorter if the ambulance service is the first provider (which can be facilitated by the education of the population and patients) and in the case of stronger chest pain.