Korean J Med.  2016 Jun;90(6):507-513. 10.3904/kjm.2016.90.6.507.

Emergency Medical Service Use among Patients with Acute ST-segment Elevation Myocardial Infarction in Jeonbuk Province

• Woo SH
• Yun KH
• Lee MR
• Kim EK
• Ko JS
• Rhee SJ
• Lee JM
• Kim NH
• Oh SK

• KMID: 2218772
• DOI: http://doi.org/10.3904/kjm.2016.90.6.507

Abstract

BACKGROUND/AIMS
The use of emergency medical services (EMSs) at the onset of pain, and the relationship between transport type and the treatment delay for acute ST-segment elevation myocardial infarction (STEMI) were evaluated using the Jeonbuk Regional Cardiovascular Center database.
METHODS
In total, 527 STEMI patients who underwent primary percutaneous coronary intervention (PCI) were enrolled in this study. Basic characteristics, socioeconomic variables, and delay factors were compared between patients that contacted an EMS as first medical contact (FMC) and patients that used other forms of FMC.
RESULTS
Only 28.8% of patients used EMS as their FMC. The patients that used EMS showed significantly shorter onset-to-balloon time than those who did not (250.7 ± 366.6 min vs. 405.9 ± 649.8 min, p = 0.001). However, 36.2% of patients that used EMS as FMC were transported to non-PCI-capable centers, which led to significantly prolonged onset-to-balloon time. Multivariate analysis revealed that transfer via another hospital (odds ratio [OR] 2.0, p < 0.001), EMS as FMC (OR 0.4, p <0.001), age > 65 years (OR 1.9, p = 0.003), and previous history of PCI (OR 0.4, p = 0.033) were independent predictors of pre-hospital delay.
CONCLUSIONS
EMS used as FMC at the onset of chest pain was an important factor for decreasing treatment delay in patients with STEMI. However, a small number of patients used EMS as FMC, and some patients that used EMS were transported to non-PCI-capable centers. Public campaigns and education are needed to raise the public awareness of STEMI and the use of EMSs.

Keyword

Myocardial infarction; Emergency medical services; Time factors

MeSH Terms

Chest Pain
Education
Emergencies*
Emergency Medical Services*
Humans
Jeollabuk-do*
Multivariate Analysis
Myocardial Infarction*
Percutaneous Coronary Intervention
Time Factors