 |
|
Decade-Long Trends and Factors Associated With Time to Hospital Presentation in Patients With Acute Myocardial Infarction
The Worcester Heart Attack Study
Robert J. Goldberg, PhD;
Jorge Yarzebski, MD, MPH;
Darleen Lessard, MS;
Joel M. Gore, MD
Arch Intern Med. 2000;160:3217-3223.
Background Duration of prehospital delay in patients with acute myocardial infarction (AMI) is receiving increasing attention given the time-dependent benefits associated with prompt use of coronary reperfusion strategies.
Objective To examine trends (1986-1997) in time to hospital presentation and factors associated with prolonged delay in a community-wide study of patients with AMI.
Methods Longitudinal study of 3837 residents of the Worcester, Mass, metropolitan area hospitalized with AMI in 7 one-year periods between 1986 and 1997 in whom information about prehospital delay was available.
Results The mean, median, and distribution of delay times exhibited either inconsistent or no changes over time. In 1986, the mean and median prehospital delay times were 4.1 and 2.2 hours, respectively; these times were 4.3 and 2.0 hours, respectively, in patients hospitalized in 1997. Overall, with no significant differences noted over time, approximately 44% of patients with AMI presented to area-wide hospitals in less than 2 hours after the onset of acute coronary symptoms. Increasing age, history of angina or diabetes, onset of symptoms in the afternoon or evening, and hospitalization in the most recent study year (1997) were significantly associated with delays of more than 2 hours in seeking hospital care after controlling for a variety of factors that might affect delay.
Conclusions The results of this population-based study suggest that a large proportion of patients with AMI continue to exhibit prolonged delay. The characteristics of many of these individuals can be identified in advance for targeted educational efforts.
From the Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester.
RELATED ARTICLE
Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2000;160(21):3332-3333.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Neighborhood Income, Health Insurance, and Prehospital Delay for Myocardial Infarction: The Atherosclerosis Risk in Communities Study
Foraker et al.
Arch Intern Med 2008;168:1874-1879.
ABSTRACT
| FULL TEXT
Factors Associated With Longer Time From Symptom Onset to Hospital Presentation for Patients With ST-Elevation Myocardial Infarction
Ting et al.
Arch Intern Med 2008;168:959-968.
ABSTRACT
| FULL TEXT
Acute Coronary Care in the Elderly, Part II: ST-Segment-Elevation Myocardial Infarction: A Scientific Statement for Healthcare Professionals From the American Heart Association Council on Clinical Cardiology: In Collaboration With the Society of Geriatric Cardiology
Alexander et al.
Circulation 2007;115:2570-2589.
ABSTRACT
| FULL TEXT
Risk factors for primary ventricular fibrillation during acute myocardial infarction: a systematic review and meta-analysis
Gheeraert et al.
Eur Heart J 2006;27:2499-2510.
ABSTRACT
| FULL TEXT
Reducing Delay in Seeking Treatment by Patients With Acute Coronary Syndrome and Stroke: A Scientific Statement From the American Heart Association Council on Cardiovascular Nursing and Stroke Council
Moser et al.
Circulation 2006;114:168-182.
ABSTRACT
| FULL TEXT
Myocardial infarction symptom recognition by the lay public: the role of gender and ethnicity.
Ratner et al.
J. Epidemiol. Community Health 2006;60:606-615.
ABSTRACT
| FULL TEXT
Clinical outcome of older patients with acute coronary syndrome over the last three decades.
Tang et al.
Age Ageing 2006;35:280-285.
ABSTRACT
| FULL TEXT
Factors Associated With Prolonged Prehospital Delay of African Americans With Acute Myocardial Infarction
Banks and Dracup
Am J Crit Care 2006;15:149-157.
ABSTRACT
| FULL TEXT
Evaluation of a Public Education Program Delivered by Firefighters on Early Recognition of a Heart Attack
Meischke et al.
Eval Health Prof 2004;27:3-21.
ABSTRACT
Epidemiology of acute myocardial infarction in the Italian CCU network: The BLITZ Study
Di Chiara et al.
Eur Heart J 2003;24:1616-1629.
ABSTRACT
| FULL TEXT
Circadian variations in acute myocardial infarction: Patients or health care delivery?
Spencer and Becker
J Am Coll Cardiol 2003;41:2143-2146.
FULL TEXT
Prehospital Delay in Patients with Acute MI: No Change in a Decade
Journal Watch Cardiology 2001;2001:8-8.
FULL TEXT
|
