Factors associated with prehospital delay in patients with ST-segment elevation acute myocardial infarction in China
Ya Guang Peng1, Jing Jing Feng2, Lu Fen Guo3
1State 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.
Insights
Prehospital delay significantly impacts ST-elevation myocardial infarction (STEMI) outcomes. Recognizing symptom onset and seeking timely medical care are crucial for improving prognosis in STEMI patients.
Area of Science:
- Cardiology
- Public Health
- Emergency Medicine
Background:
- Prehospital delay is a critical prognostic factor for ST-elevation myocardial infarction (STEMI).
- Limited research has explored STEMI prehospital delay predictors using multivariate analysis in China.
- Understanding these predictors is vital for improving patient outcomes.
Purpose of the Study:
- To identify sociodemographic and clinical predictors of prehospital delay in STEMI patients.
- To analyze factors influencing delay in seeking emergency care for STEMI.
- To inform targeted interventions for reducing prehospital delay.
Main Methods:
- A cohort of 1088 hospitalized STEMI patients was analyzed.
- Sociodemographic data, medical history, and symptom onset details were collected from medical records.
- Bivariate and multivariate analyses identified factors associated with prehospital delay.
Main Results:
- The median prehospital delay time (PDT) was 130 minutes.
- Eight predictors of prehospital delay were identified, including education level, MI history, vertigo, ambulance use, daytime onset, home onset, anterior, and posterior wall MI.
- Mortality was slightly higher in the prolonged delay group (>120 minutes) but not statistically significant.
Conclusions:
- Symptom onset characteristics significantly influence STEMI prehospital delay.
- Interventions should incorporate onset-related factors and enhance emergency education for patients and families.
- Public education on STEMI symptoms is essential to improve recognition and reduce delay.
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.
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