Community-based gender perspectives of triage and treatment in suspected myocardial infarction

Ravn-Fischer, Annica; Caidahl, Kenneth; Hartford, Marianne; Karlsson, Thomas; Kihlgren, Stefan; Perers, Elisabeth; Rashed, H.; Johanson, Per; Herlitz, Johan

doi:10.1016/j.ijcard.2010.10.023

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…The lower rate of treatment at a CCU among women compared with men observed in this study has previously been reported from U.S., U.K. and Italy [2], [7], [19], [20] and from small regional studies in Sweden [21], [22], [23]. We were able to confirm this finding even after taking into account age, educational level as an indication of SEP, country of birth, and a number of other potential confounders.…”

Section: Discussionsupporting

confidence: 88%

Likelihood of Treatment in a Coronary Care Unit for a First-Time Myocardial Infarction in Relation to Sex, Country of Birth and Socioeconomic Position in Sweden

et al. 2013

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ObjectiveTo examine the relationship between sex, country of birth, level of education as an indicator of socioeconomic position, and the likelihood of treatment in a coronary care unit (CCU) for a first-time myocardial infarction.DesignNationwide register based study.SettingSweden.Patients199 906 patients (114 387 men and 85,519 women) of all ages who were admitted to hospital for first-time myocardial infarction between 2001 and 2009.Main outcome measuresAdmission to a coronary care unit due to myocardial infarction.ResultsDespite the observed increasing access to coronary care units over time, the proportion of women treated in a coronary care unit was 13% less than for men. As compared with men, the multivariable adjusted odds ratio among women was 0.80 (95% confidence interval 0.77 to 0.82). This lower proportion of women treated in a CCU varied by age and year of diagnosis and country of birth. Overall, there was no evidence of a difference in likelihood of treatment in a coronary care unit between Sweden-born and foreign-born patients. As compared with patients with high education, the adjusted odds ratio among patients with a low level of education was 0.93 (95% confidence interval 0.89 to 0.96).ConclusionsForeign-born and Sweden-born first-time myocardial infarction patients had equal opportunity of being treated in a coronary care unit in Sweden; this is in contrast to the situation in many other countries with large immigrant populations. However, the apparent lower rate of coronary care unit admission after first-time myocardial infarction among women and patients with low socioeconomic position warrants further investigation.

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Section: Discussionsupporting

confidence: 88%

Likelihood of Treatment in a Coronary Care Unit for a First-Time Myocardial Infarction in Relation to Sex, Country of Birth and Socioeconomic Position in Sweden

et al. 2013

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“…This is problematic as it indicates an inequality in EMS care of patients with chest pain based on sex. Sex inequalities in AMI care has been shown in previous in-hospital research [ 14 – 16 ] and also regarding direct admission to PCI [ 17 ] and time to acetylsalicylic acid treatment [ 18 ]. But, to the best of our knowledge, it has not previously been reported that women with chest pain are less likely than men to receive pharmaceutical treatment already in the prehospital phase.…”

Section: Discussionmentioning

confidence: 95%

Guideline adherence among prehospital emergency nurses when caring for patients with chest pain: a prospective cohort study

Wibring

Lingman

Herlitz

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background The emergency medical services (EMS) use guidelines to describe optimal patient care for a wide range of clinical conditions and symptoms. The intent is to guide personnel to provide patient care in line with best practice. The aim of this study is to describe adherence to such guidelines among prehospital emergency nurses (PENs) when caring for patients with chest pain. Objective To describe guideline adherence among PENs when caring for patients with chest pain. To investigate whether guideline adherence is associated with patient age, sex or final diagnosis of acute myocardial infarction on hospital discharge. Methods Guideline adherence in terms of patient examination and pharmaceutical treatment was analysed in a cohort of 2092 EMS missions carried out in 2018 in Region Halland, Sweden. Multivariate regression was used to describe how guideline adherence is associated with patient age, sex and diagnosis on hospital discharge. Results Guideline adherence was high regarding examination of vital signs (93%) and electrocardiogram (ECG) registration (96%) but lower in terms of pharmaceutical treatment (ranging from 28 to 90%). Adherence was increased in cases in which the patient ended up with acute myocardial infarction (AMI) as diagnosis on discharge. Patients with AMI were given acetylsalicylic acid by PENs in 50% of cases. Women were less likely than men to receive treatment with acetylsalicylic acid and oxycodone. Conclusions Guideline adherence among PENs when caring for patients with chest pain is satisfactory in terms vital signs and ECG registration. Regarding pharmaceutical treatment guideline adherence is defective. Improved adherence is mainly associated with male sex in patients and a diagnosis of AMI on hospital discharge. Defective adherence excludes measures known to improve patients’ prognoses such as treatment with acetylsalicylic acid.

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Accuracy in ED Triage for Symptoms of Acute Myocardial Infarction

Sanders¹,

DeVon²

2016

Journal of Emergency Nursing

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Community-based gender perspectives of triage and treatment in suspected myocardial infarction

Cited by 4 publications

References 20 publications

Likelihood of Treatment in a Coronary Care Unit for a First-Time Myocardial Infarction in Relation to Sex, Country of Birth and Socioeconomic Position in Sweden

Likelihood of Treatment in a Coronary Care Unit for a First-Time Myocardial Infarction in Relation to Sex, Country of Birth and Socioeconomic Position in Sweden

Guideline adherence among prehospital emergency nurses when caring for patients with chest pain: a prospective cohort study

Accuracy in ED Triage for Symptoms of Acute Myocardial Infarction

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