PMID- 28367010
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220409
IS  - 0974-2700 (Print)
IS  - 0974-519X (Electronic)
IS  - 0974-2700 (Linking)
VI  - 10
IP  - 2
DP  - 2017 Apr-Jun
TI  - Prehospital delay and time to reperfusion therapy in ST elevation myocardial 
      infarction.
PG  - 64-69
LID - 10.4103/0974-2700.201580 [doi]
AB  - BACKGROUND: Despite efforts aimed at reducing the prehospital delay and treatment 
      delay, a considerable proportion of patients with ST elevation myocardial 
      infarction (STEMI) present late and receive the reperfusion therapy after 
      unacceptably long time periods. This study aimed at finding out the patients' 
      decision delay, prehospital delay, door-to-electrocardiography (ECG), 
      door-to-needle, and door-to-primary percutaneous coronary intervention (PCI) 
      times and their determinants among STEMI patients. MATERIALS AND METHODS: A 
      cross-sectional study conducted among 96 patients with STEMI admitted in a 
      tertiary care center in South India. The data were collected using interview of 
      the patients and review of records. The distribution of the data was assessed 
      using Kolmogorov-Smirnov test, and the comparisons of the patients' decision 
      delay, prehospital delay, and time to start reperfusion therapy with the 
      different variables were done using Mann-Whitney U-test or Kruskal-Wallis test 
      based on the number of groups. RESULTS: The mean (standard deviation) and median 
      (range) age of the participants were 55 (11) years and 57 (51) years, 
      respectively. The median patients' decision delay, prehospital delay, 
      door-to-ECG, door-to-needle, and door-to-primary PCI times were 75, 290, 12, 75, 
      110 min, respectively. Significant factors associated (P < 0.05) with patients' 
      decision delay were alcoholism, symptom progression, and attempt at symptom 
      relief measures at home. Prehospital delay was significantly associated (P < 
      0.05) with domicile, difficulty in arranging money, prior consultation at study 
      center, place of symptom onset, symptom interpretation, and mode of 
      transportation. CONCLUSIONS: The prehospital delay time among the South Indian 
      population is still unacceptably high. Public education, improving the systems of 
      prehospital care, and measures to improve the patient flow and management in the 
      emergency department are essentially required. The time taken to take ECG and to 
      initiate reperfusion therapy in this study points to scope for improvement to 
      meet the American Heart Association recommended timings.
FAU - George, Linsha
AU  - George L
AD  - College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and 
      Research, Puducherry, India.
FAU - Ramamoorthy, Lakshmi
AU  - Ramamoorthy L
AD  - College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and 
      Research, Puducherry, India.
FAU - Satheesh, Santhosh
AU  - Satheesh S
AD  - Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education 
      and Research, Puducherry, India.
FAU - Saya, Rama Prakasha
AU  - Saya RP
AD  - Department of General Medicine, Kanachur Institute of Medical Sciences, 
      Mangalore, Karnataka, India.
FAU - Subrahmanyam, D K S
AU  - Subrahmanyam DK
AD  - Department of General Medicine, Jawaharlal Institute of Postgraduate Medical 
      Education and Research, Puducherry, India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - J Emerg Trauma Shock
JT  - Journal of emergencies, trauma, and shock
JID - 101493921
PMC - PMC5357880
OTO - NOTNLM
OT  - Door-to-needle
OT  - door-to-primary percutaneous coronary intervention
OT  - myocardial infarction
OT  - prehospital delay
OT  - reperfusion therapy
COIS- There are no conflicts of interest.
EDAT- 2017/04/04 06:00
MHDA- 2017/04/04 06:01
PMCR- 2017/04/01
CRDT- 2017/04/04 06:00
PHST- 2017/04/04 06:00 [entrez]
PHST- 2017/04/04 06:00 [pubmed]
PHST- 2017/04/04 06:01 [medline]
PHST- 2017/04/01 00:00 [pmc-release]
AID - JETS-10-64 [pii]
AID - 10.4103/0974-2700.201580 [doi]
PST - ppublish
SO  - J Emerg Trauma Shock. 2017 Apr-Jun;10(2):64-69. doi: 10.4103/0974-2700.201580.