Prehospital delay for acute coronary syndrome in China
Yingjuan Cao1, Patricia M Davidson, Michelle DiGiacomo
1Qilu Hospital of Shandong University, P. R. China.
Insights
Prehospital delay in acute coronary syndrome (ACS) is prolonged by older age, attributing symptoms to non-cardiac causes, lack of insurance, poor transport, and female sex. Targeted interventions are needed for vulnerable populations in China.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Timely reperfusion therapy is crucial for acute coronary syndrome (ACS).
- Prehospital delay in seeking care for ACS is a significant global challenge.
- Understanding factors contributing to this delay is vital for improving patient outcomes.
Purpose of the Study:
- To comprehensively review the existing scientific literature on prehospital delay for ACS in China.
- To identify key factors contributing to delayed care-seeking behavior among Chinese ACS patients.
- To inform the development of targeted interventions to reduce prehospital delay.
Main Methods:
- Systematic literature search of electronic databases and hand searching.
- Keywords included "prehospital delay," "acute coronary syndrome," "China," and related terms.
- Review of 28 identified studies using a standardized data extraction tool.
Main Results:
- Older age, attributing symptoms to non-cardiac causes, lack of health insurance, and poor transportation access were associated with longer prehospital delay.
- Female sex was also identified as a factor contributing to delayed care-seeking.
- These findings highlight multifactorial influences on prehospital delay in the Chinese population.
Conclusions:
- Health system reforms in China are essential to address prehospital delay in ACS.
- Particular attention should be paid to vulnerable groups, including older adults, women, and those with limited insurance or transportation.
- Developing targeted, evidence-based interventions, drawing on national and international experiences, is crucial for reducing ACS prehospital delay.
Background:
Despite the effectiveness of timely reperfusion therapy for acute coronary syndrome, prehospital delay remains a global concern.
Objective:
This article assesses the state-of-the-science regarding prehospital delay for acute coronary syndrome in China.
Method:
Electronic databases and hand searching were undertaken using key words such as prehospital delay, care-seeking delay, coronary heart disease, heart disease, acute coronary syndrome, unstable angina pain, acute myocardial infarction, cardiovascular disease, chest pain, and Chin (China/Chinese). The Chinese search was supervised by a Chinese health librarian.
Results:
Based on the search criteria, 28 studies were identified and reviewed using a standardized data extraction tool. Older age, attribution of symptoms to noncardiac causes, lack of health insurance coverage, poor access to transportation, and female sex were identified as contributing to prehospital delay.
Conclusion:
Health system reforms in China are necessary, particularly with regard to addressing the needs of older people, women, and other vulnerable populations in the context of the rising number of people with coronary heart disease. Developing targeted strategies, learned from both national and international experience, are required to develop targeted interventions.
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