Duration of symptoms prior to hospitalization and mode of admission in acute myocardial infarction
Aurup, P.; Cintin, C.; Nielsen, J.D.; Jensen, G.
Ugeskrift for Laeger 150(30): 1836-1838
1988
ISSN/ISBN: 0041-5782 PMID: 3413853 Document Number: 319356
The time which elapsed from the commencement of symptoms until arrival in a coronary unit was registered in a total of 306 patients admitted consecutively with the diagnosis of acute myocardial infarction (AMI)/or observation for AMI. A total of 121 (40%) of the patients were women and 185 (61%) were men. Acute myocardial infarction was diagnosed in 75 men and 44 women. The average age of the women was 71 years (39-89) and 64 years for men (38-90). The lethality during hospitalization in the group of patients with verified acute myocardial infarction was 18% as compared with 1.6% in the group of patients in whom acute myocardial infarction was disproved. The delay was 15.2 hours on an average for the patients without histories of cardiac disease and 7.4 hours for patients with previous cardiac symptoms. The greatest delay in all of the groups was in the pre-hospital phase, primarily as the time from the commencement of symptoms until the doctor or ambulance was summoned. The number of patients with positive ECG findings who arrived within six hours was 50 (16%). No correlation was observed between the delay and the age or sex. Various ways of reducing both the patient-related and the system related delays are discussed and particular attention is drawn to the importance of reducing delay in hospitalization caused by patients by means of better information about improved therapeutic methods, particularly thrombolysis, available on rapid admission.