PMID- 28598044
OWN - NLM
STAT- MEDLINE
DCOM- 20180918
LR  - 20220318
IS  - 0004-5772 (Print)
IS  - 0004-5772 (Linking)
VI  - 65
IP  - 5
DP  - 2017 May
TI  - A Study of Prehospital Delay Patterns in Acute Myocardial Infarction in an Urban 
      Tertiary Care Institute in Mumbai.
PG  - 24-27
AB  - OBJECTIVE: There is now increasing awareness about the need for early diagnosis 
      in patients presenting with chest pain. Pre-hospital delay remains a major hurdle 
      in the institution of early reperfusion therapy, which is crucial in salvaging 
      'at-risk' myocardium and reducing adverse cardiovascular events following ST 
      elevation myocardial infarction (STEMI). This study aims to determine the 
      incidence and the determinants of delayed presentation STEMI and the potential 
      impact of such delay on adverse cardiovascular outcomes. METHODS: We 
      prospectively evaluated all patients who were admitted in the emergency 
      department of our hospital with STEMI from March 2014 to February 2016. Data was 
      collected sequentially at the time of admission, discharge and during follow-up. 
      Patients were evaluated with serial ECGs, continuous ECG monitoring and 
      echocardiography. RESULTS: Out of 1386 patients with STEMI, delayed presentation 
      was seen in 1148 (> 2 hrs) and 805 (> 4 hrs) patients. The duration from onset of 
      symptoms to the presentation in the emergency room (pre-hospital delay) was 228 +/- 
      341minutes.The door to needle time was 34 +/- 24 minutes. The major factors for 
      pre-hospital delay were misinterpretation of symptoms (45%) and transportation 
      problems (27%). CONCLUSIONS: The problem of pre-hospital delay continues to 
      remain a major hurdle in initiating timely reperfusion therapy in patients with 
      acute STEMI. Lack of awareness and poor transportation facilities are the major 
      contributors. It should be the goal of STEMI care programmes of the future to 
      make a concerted effort to addressing these factors, in order to optimize the 
      benefit of reperfusion therapy for this high risk group of patients.
FAU - Khan, Ashar
AU  - Khan A
AD  - Senior Resident.
FAU - Phadke, Milind
AU  - Phadke M
AD  - Associate Professor.
FAU - Lokhandwala, Yash Y
AU  - Lokhandwala YY
AD  - Visiting Consultant.
FAU - Nathani, Pratap J
AU  - Nathani PJ
AD  - Professor and HOD, LTMMC and GH, Mumbai, Maharashtra.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - India
TA  - J Assoc Physicians India
JT  - The Journal of the Association of Physicians of India
JID - 7505585
SB  - IM
MH  - *Diagnostic Self Evaluation
MH  - Female
MH  - Hospitals, Urban
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Acceptance of Health Care
MH  - Prospective Studies
MH  - ST Elevation Myocardial Infarction/*diagnosis/*therapy
MH  - Tertiary Care Centers
MH  - *Time-to-Treatment
MH  - *Transportation
EDAT- 2017/06/10 06:00
MHDA- 2018/09/19 06:00
CRDT- 2017/06/10 06:00
PHST- 2017/06/10 06:00 [entrez]
PHST- 2017/06/10 06:00 [pubmed]
PHST- 2018/09/19 06:00 [medline]
PST - ppublish
SO  - J Assoc Physicians India. 2017 May;65(5):24-27.