Patient delay and use of ambulance by patients with chest pain

Ingarfield, Sharyn L; Jacobs, Ian; Jelinek, George A; Mountain, David

doi:10.1111/j.1742-6723.2005.00726.x

Cited by 21 publications

(28 citation statements)

References 13 publications

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“…Despite numerous studies on the topic of patient-caused delays, 13,24,25 only one small study has specifically examined patients who have chest pain in association with acute myocardial infarction. 34 The predictors of patient-caused delay in our study were similar to those reported in previous studies of patients with acute myocardial infarction, who may or may not have had chest pain. 12,24,26,35 In other studies, older patients were more likely to present late, 12,13,24,25,35 but this was thought to be due in part to atypical symptoms, which are common in elderly people.…”

Section: Discussionsupporting

confidence: 79%

Effect of marriage on duration of chest pain associated with acute myocardial infarction before seeking care

Atzema¹,

Austin²,

Huynh³

et al. 2011

Canadian Medical Association Journal

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Background: Coronary artery disease is the most common cause of death in the Western world, and being married decreases the risk of death from cardiovascular causes. We aimed to determine whether marital status was a predictor of the duration of chest pain endured by patients with acute myocardial infarction before they sought care and whether the patient's sex modified the effect. Methods:We conducted a retrospective, population-based cohort analysis of patients with acute myocardial infarction admitted to 96 acute care hospitals in Ontario, Canada, from April 2004 to March 2005. We excluded patients who did not experience chest pain. Using multivariable regression analyses, we assessed marital status in relation to delayed presentation to hospital (more than six hours from onset of pain), both overall and strat ified by sex. In patients who reported the exact duration of chest pain, we assessed the effect of marital status on the delay in seeking care. Interpretation: Among men experiencing acute myocardial infarction with chest pain, being married was associated with significantly earlier presentation for care, a benefit that was not observed for married women. Earlier presentation for medical care appears to be one reason for the observed lower risk of cardiovascular death among married men, relative to their single counterparts. Results AbstractResearch

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Section: Discussionsupporting

confidence: 79%

Effect of marriage on duration of chest pain associated with acute myocardial infarction before seeking care

Atzema¹,

Austin²,

Huynh³

et al. 2011

Canadian Medical Association Journal

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“…Almost less than one-third of the patients preferred ambulance for transportation and this rate was lower than the reported rates with previous studies from European countries and Australia but similar to the rates of China (4,(6)(7)(8). Instead of using ambulance most of our patients carried out the transportation to hospital in unsafe and inappropriate conditions for ACS.…”

Section: Discussioncontrasting

confidence: 52%

“…A questionnaire, which was formed by the investigators of the study according to the previous studies, was used (3,4,6,7). The questionnaire was prepared in order to assess patients' demographic, social and clinical characteristics, characteristic and severity of chest pain, presence of accompanying symptoms, the time between the onset of symptoms and arrival to the hospital and mode of transport to the hospital.…”

Section: Data Collectionmentioning

confidence: 99%

Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey

Demirkan¹,

Ege²,

Doğan³

et al. 2013

Anadolu Kardiyol Derg

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Objective: In this study, we aimed to identify the factors influencing the use of ambulance among patients admitted to two Turkish hospitals with acute coronary syndrome (ACS). Methods: Overall, 330 with a mean age of 55±13 years, hospitalized patients with ACS at 2 different hospitals were included in this prospective cohort study. The factors influencing the use of ambulance hospital were investigated through a questionnaire. The comparisons were made between two groups regarding use of ambulance. The predictors of the use of ambulance were determined using multiple logistic regression analysis. Results: Despite the high rate of knowing the emergency service number of "112", of the 330 patents, only 96 (29%) used ambulance. Ambulance users had shorter arrival duration with median of 60 min vs 120 min (p=0.03). Presenting with ST elevation myocardial infarction (OR=3.127, 95% CI: 1.555-6.2877, p<0.001), severity of chest pain (OR=2.665, 95% CI: 1.938-3.665, p<0.001), presence of accompanying symptoms such as dyspnea (OR= 5.510, 95% CI: 2.614-11.614, p<0.001), dizziness (OR=4.172, 95% CI: 1.901-9.154, p<0.001) and vomiting (OR=3.756, 95% CI: 1.521-9.272, p=0.004), knowledge of cardiac risk factors (OR=10.512, 95% CI: 4.497-24.572, p<0.001) or chest pain related to heart attack and the importance of quickly seeking for medical care by calling ambulance (OR= 4.184, 95% CI: 2.528-6.926, p<0.001) are the factors associated with ambulance use. Conclusion: Using ambulance was in a very low rate among our study patients with ACS. Severity of symptoms, type of ACS and knowledge are seemed to be related with increased ambulance use. Informative health educational programs can be organized to achieve a behavioral change in using of ambulance. (Anadolu Kardiyol Derg 2013; 13: 516-22) Key words: Ambulance use, acute coronary syndrome, regression analysis Original Investigation Özgün Araşt›rma 516ÖZET Amaç: Ambulans kullanılması akut koroner sendromlu (AKS) hastaların hastaneye nakli sırasında sadece hızlı değil, aynı zamanda güvenilir ulaşım şeklidir. Bu çalışma AKS tanısı ile iki ayrı merkeze başvuran hastalarda ambulans kullanımını etkileyen faktörlerin belirlenmesi amaçlanmıştır. Yöntemler: Türkiye'de 2 ayrı hastanede AKS tanısı ile hastaneye yatırılan ve yaş ortalaması 55±13 olan toplam 330 hasta bu prospektif kohort çalışmaya dahil edilmiştir. Hastaların hastaneye ulaşım şeklini etkileyen faktörler bir anket formu aracılığıyla araştırılmıştır. Hastalar ambulans kullanıp kullanmadıklarına göre iki gruba ayrılarak karşılaştırmalar yapılmıştır. Ambulans kullanımını belirleyen faktörler çoklu lojistik regresyon analizi ile değerlendirilmiştir. Bulgular: Acil servis numarası "112"nin yüksek oranda biliniyor olmasına rağmen, 330 hastanın sadece 96'sı (%29) ambulans kullanırken, geri kalan 234 (%71) hasta kendi ulaşımını sağlamıştır. Ambulans kullananların hastaneye ulaşım süreleri (ortanca 120 dakikaya karşılık 60 dakika olarak) daha kısa olmuştur (p=0,03). ST yükselmeli miyokart enfarktüsü ile başvurma (OR=3,127, %9...

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“…In Europe and australia, the figures often reach >50%, [40][41][42][43] whereas in the United States, the figures are often around 50% or lower. 35,44,45 More than two-third of the patients with StEMI in Beijing presented to the hospital by self-transport.…”

Section: Early Accessmentioning

confidence: 99%

The Chain of Survival for ST-Segment Elevation Myocardial Infarction

El-Deeb

2013

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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Although coronary heart disease is the leading cause of morbidity and mortality in the Middle East (ME), not much is known about patients with ST-segment elevation myocardial infarction (STEMI) from this region. The STEMI Chain of Survival can be used to target regional improvements in patient care. We tried to adopt a modified chain of survival for STEMI to highlight the challenges and difficulties and the possible solutions to improve the STEMI care in the Middle East based on the few data available.

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Patient delay and use of ambulance by patients with chest pain

Abstract: Education programmes should continue to emphasize that chest pain is a potential medical emergency and an ambulance should be called. GPs should consider developing an action plan to manage patients presenting with chest pain.

Cited by 21 publications

References 13 publications

Effect of marriage on duration of chest pain associated with acute myocardial infarction before seeking care

Effect of marriage on duration of chest pain associated with acute myocardial infarction before seeking care

Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey

The Chain of Survival for ST-Segment Elevation Myocardial Infarction

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