Detecting failed thrombolysis in the accident and emergency department

Spiers, Christine

doi:10.1016/s0965-2302(03)00036-5

Cited by 1 publication

(1 citation statement)

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“…Although many advances have occurred in the last two decades, resulting in an important impact on morbidity and mortality, the postponing of treatment due to the delay in seeking medical attention is still a major problem in daily clinical practice. 4 Evidence in the literature indicates that female gender, marital status, Diabetes Mellitus (DM), Systemic Arterial Hypertension (SAH), atrial fibrillation, and age are predictors of hospital arrival delay. 5 - 10 …”

Section: Introductionmentioning

confidence: 99%

Independent Predictors of Late Presentation in Patients with ST-Segment Elevation Myocardial Infarction

Rodrigues

Melleu

Schmidt

et al. 2018

Arquivos Brasileiros De Cardiologia

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BackgroundIn patients with acute ST-segment elevation myocardial infarction (STEMI), the time elapsed from symptom onset to receiving medical care is one of the main mortality predictors.ObjectiveTo identify independent predictors of late presentation in patients STEMI representative of daily clinical practice.MethodsAll patients admitted with a diagnosis of STEMI in a reference center between December 2009 and November 2014 were evaluated and prospectively followed during hospitalization and for 30 days after discharge. Late presentation was defined as a time interval > 6 hours from chest pain onset until hospital arrival. Multiple logistic regression analysis was used to identify independent predictors of late presentation. Values of p < 0.05 were considered statistically significant.ResultsA total of 1,297 patients were included, with a mean age of 60.7 ± 11.6 years, of which 71% were males, 85% Caucasians, 72% had a mean income lower than five minimum wages and 66% had systemic arterial hypertension. The median time of clinical presentation was 3.00 [1.40-5.48] hours, and approximately one-quarter of the patients had a late presentation, with their mortality being significantly higher. The independent predictors of late presentation were Black ethnicity, low income and diabetes mellitus, and a history of previous heart disease was a protective factor.ConclusionBlack ethnicity, low income and diabetes mellitus are independent predictors of late presentation in STEMI. The identification of subgroups of patients prone to late presentation may help to stimulate prevention policies for these high-risk individuals.

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Section: Introductionmentioning

confidence: 99%