EPIDEMIOLOGY OF AVOIDABLE DELAY IN THE CARE OF PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION IN ITALY - A GISSI-GENERATED STUDY

被引:35
作者
FRANZOSI, MG [1 ]
FRESCO, C [1 ]
GERACI, E [1 ]
MAGGIONI, AP [1 ]
TAVAZZI, L [1 ]
TOGNONI, G [1 ]
VALAGUSSA, F [1 ]
ZOTTI, AM [1 ]
机构
[1] OSPED CERVELLO,PALERMO,ITALY
关键词
D O I
10.1001/archinte.1995.00430140035003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The delay between onset of symptoms and coronary care unit admission is decisive in the outcome of patients with acute myocardial infarction. Objective: To evaluate the influence of the factors that affect the delay in acute myocardial infarction treatment. Methods: Multicenter case-control study conducted by 118 coronary care units in Italy. The median and mean times in cases and controls were compared for decision time, home-to-hospital time, and in-hospital time, and the influence of several potential risk factors on the delay was evaluated by comparison of patients admitted more than 6 hours after onset with those admitted within 6 hours after onset. Results: Among 5301 patients with acute myocardial infarction, 590 who came to a coronary care unit after 12 hours were considered cases. Controls included 600 patients treated within 2 hours, 603 between 2 and 6 hours, and 466 between 6 and 12 hours. The median decision time among cases was 50-fold higher than that of controls who presented within 2 hours. Home-to-hospital rime and in-hospital time appeared to play a less important role. Among the patient-related variables, advanced age, living alone, low intensity of initial symptoms, history of diabetes, strong pain at onset of the infarction, occurrence of symptoms at night, and involvement of a general practitioner seemed to affect delay significantly. Conclusion: Interventions aimed at reducing the delay in acute myocardial infarction treatment should primarily focus on the help-seeking behavior of patients.
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收藏
页码:1481 / 1488
页数:8
相关论文
共 29 条
[1]  
[Anonymous], 1990, Lancet, V336, P65
[2]  
[Anonymous], 1986, Lancet, V1, P397
[3]   TIME DELAYS IN PROVISION OF THROMBOLYTIC TREATMENT IN 6 DISTRICT HOSPITALS [J].
BIRKHEAD, JS .
BMJ-BRITISH MEDICAL JOURNAL, 1992, 305 (6851) :445-448
[4]   CONSEQUENCES OF A MEDIA CAMPAIGN FOCUSING ON DELAY IN ACUTE MYOCARDIAL-INFARCTION [J].
BLOHM, M ;
HERLITZ, J ;
HARTFORD, M ;
KARLSON, BW ;
RISENFORS, M ;
LUEPKER, RV ;
SJOLIN, M ;
HOLMBERG, S .
AMERICAN JOURNAL OF CARDIOLOGY, 1992, 69 (04) :411-413
[5]  
BRESLOW NE, 1980, INT AGENCY RES CANCE, V32
[6]  
Fibrinolytic 'Therapy Trialists' (FTT) Collaborative Group, 1994, LANCET, V343, P311
[7]  
FRESCO C, 1990, Giornale Italiano di Cardiologia, V20, P361
[8]   PATIENT DELAY AND RECEIPT OF THROMBOLYTIC THERAPY AMONG PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION FROM A COMMUNITY-WIDE PERSPECTIVE [J].
GOLDBERG, RJ ;
GURWITZ, J ;
YARZEBSKI, J ;
LANDON, J ;
GORE, JM ;
ALPERT, JS ;
DALEN, PM ;
DALEN, JE .
AMERICAN JOURNAL OF CARDIOLOGY, 1992, 70 (04) :421-425
[9]  
GRAY D, 1993, LANCET, V341, P64
[10]   FACTORS CONTRIBUTING TO DELAY IN RESPONDING TO SIGNS AND SYMPTOMS OF ACUTE MYOCARDIAL INFARCTION [J].
HACKETT, TP ;
CASSEM, NH .
AMERICAN JOURNAL OF CARDIOLOGY, 1969, 24 (05) :651-&