J Lipid Atheroscler.  2016 Jun;5(1):21-26. 10.12997/jla.2016.5.1.21.

Factors Related to Pre-hospital Delay in Korean Patients with ST-segment Elevation Myocardial Infarction: A Data from the Province of Jeonbuk Regional Cardiovascular Center

• Lee MR
• Yun KH
• Kim DH
• Kang S
• Kim YJ
• Woo SH
• Jeong YH
• Kim YC
• Lee YH
• Lee JM
• Ko JS
• Rhee SJ
• Kim NH
• Oh SK

• KMID: 2328835
• DOI: http://doi.org/10.12997/jla.2016.5.1.21

Abstract

OBJECTIVE
Despite successful efforts to shorten the door-to-balloon time in patients with ST-segment elevation myocardial infarction (STEMI), pre-hospital delayremains a problem. We evaluated the factors related to pre-hospital delay using the Jeonbuk regional cardiovascular center database.
METHODS
From 2010 to 2013, a total of 384 STEMI patients were enrolled. We analyzed the onset time, door time, and balloon time, and the patients were grouped according to pre-hospital delay (120 minutes). Clinical and socio-demographic variables were compared.
RESULTS
53.2% of patients had prolonged onset-to-door time (median 130, interquartile range [IQR] 66~242 minutes), and 68.5% of patients did not achieve <120 minute of total ischemic time (median 175, IQR 110~304 minutes). Pre-hospital delay was more frequent in patients with old age, female, no local residence, low education level, transfer via other hospital and no use of emergency squad (119). Only 20% of patients used 119, and 119 team responded in a prompt manner (call to scene time 6 min), but 41.6% of patients was transported to non-PCI-capable hospitals. Multivariate analysis revealed that transfer via other hospital [Odds ratio (OR) 2.5, 95% confidence interval (CI) 1.6-4.1, p<0.001), use of 119 (OR 0.4, 95% CI 0.2-0.6, p<0.001), age >60 years (OR 1.8, 95% CI 1.1-3.0, p=0.031) and hypertension (OR 1.9, 95% CI 1.2-2.9, p=0.047) were independent predictors of pre-hospital delay.
CONCLUSIONS
The present study demonstrated a significant pre-hospital delay in the treatment of STEMI patients in the Province of Jeonbuk. Public campaigns and education are needed to raise the public awareness of STEMI and the use of 119.

Keyword

Myocardial infarction; Time-to-Treatment; Emergency medical services

MeSH Terms

Education
Emergencies
Emergency Medical Services
Female
Humans
Hypertension
Jeollabuk-do*
Multivariate Analysis
Myocardial Infarction*
Time-to-Treatment

Figure

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  Fig. 1 Components of time delay in patients with ST-segment elevation myocardial infarction.

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