Patients with acute myocardial infarction using ambulance or private transport to reach definitive care: which mode is quicker?

Li, Song; Yan, Hong‐Bin; Hu, Dayi

doi:10.1111/j.1445-5994.2009.01944.x

Cited by 14 publications

(10 citation statements)

References 21 publications

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“…It could be related to unavailability of ambulance at the time of event or a decision made in search of shorter time to medical care. In 2010, Song published an article comparing modes of transportation in case of an AMI in terms of efficacy and patient selection [15]. His results were very similar to ours in that 62.7% of the patients arrived in private transportation whereas only 37.3% arrived on ambulance.…”

Section: Discussionsupporting

confidence: 70%

“…However, if arrival to hospital is the main goal, then using a private transport is much faster and less dependent for patients and relatives. Nevertheless, when using administration of reperfusion therapy as a more rigorous measure of treatment initiation, then use of ambulance was associated with a significant decrease in door-to-balloon time [15]. This is an area to be investigated in order to assess if our population would absolutely benefit from increased implementation of EMS in order to reduce mortality and complications in patients presenting with AMI.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiological Profile of Hispanics Admitted With Acute Myocardial Infarction in Puerto Rico: The Experience of 2007, 2009 and 2011

et al. 2017

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BackgroundA limited number of studies have been published about coronary artery disease in Hispanics, particularly among the Puerto Rican population. The aim of this study was to present a clinical epidemiological profile and management practices in patients hospitalized in Puerto Rico with acute myocardial infarction (AMI).MethodsThis secondary data analysis from the Puerto Rico Cardiovascular Surveillance Study included 6,162 patients at 19 hospitals in Puerto Rico, during years 2007, 2009 and 2011.ResultsThe mean age of the patients diagnosed with AMI was 67 ± 13.6 years old, with women being older than men (P < 0.001). Women had a different risk factor burden when compared to men. Car/walked in was the principal mode of hospital transportation (65.9%). Women received less medications and cardiac procedures when compared to men. While no significant differences in length of hospital stay (LOS) were observed between genders, in-hospital mortality rate was higher in females when compared with males (6.5% vs. 4.5%; P < 0.001).ConclusionPrompt initiatives should be implemented to raise awareness, reduce gender disparities and improve outcomes in patients hospitalized with an AMI in Puerto Rico.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Epidemiological Profile of Hispanics Admitted With Acute Myocardial Infarction in Puerto Rico: The Experience of 2007, 2009 and 2011

et al. 2017

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“…If one considers that initial antiischemic treatment is often delivered by EMS, then EMS use would certainly lead to shorter delays to medical contact and treatment. 19,20 The magnitude of our findings is even more striking when they are considered in the context of the impact made by recent national campaigns to improve STEMI systems of care (eg, the Door-to-Balloon campaign was associated with a 14-minute reduction in door-to-balloon times). 21 Furthermore, use of EMS transport was associated with expedited in-hospital STEMI care.…”

Section: Impact On Process Of Care Measuresmentioning

confidence: 89%

Use of Emergency Medical Service Transport Among Patients With ST-Segment–Elevation Myocardial Infarction

et al. 2011

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Background-Activation of emergency medical services (EMS) is critical for the early triage and treatment of patients experiencing ST-segment-elevation myocardial infarction, yet data regarding EMS use and its association with subsequent clinical care are limited. Methods and Results-We performed an observational analysis of 37 634 ST-segment-elevation myocardial infarction patients treated at 372 US hospitals participating in the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines between January 2007 and September 2009, and examined independent patient factors associated with EMS transportation versus patient self-transportation. We found that EMS transport was used in only 60% of ST-segment-elevation myocardial infarction patients. Older patients, those living farther from the hospital, and those with hemodynamic compromise were more likely to use EMS transport. In contrast, race, income, and education level did not appear to be associated with the mode of transport.

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“…[17][18][19][20] Although isolated transportation times were shorter for private transportation, patients with myocardial infarction admitted by EMS had significantly shorter time intervals to definite treatment, such as door-toballoon or door-to-needle times. 8,20,21 With increasing information about CPUs in the population, patients refer themselves to a CPU in the case of acute chest pain or with other acute problems presumably of cardiac origin. In current ESC guidelines on myocardial revascularization self-referral is already included in the myocardial infarction patient pathway.…”

Section: Discussionmentioning

confidence: 99%

Self-referral to chest pain units: results of the German CPU-registry

Nowak

Giannitsis

Riemer

et al. 2012

European Heart Journal: Acute Cardiovascular Care

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Background: Chest pain units (CPUs) are increasingly established in emergency cardiology services. With improved visibility of CPUs in the population, patients may refer themselves directly to these units, obviating emergency medical services (EMS). Little is known about characteristics and outcomes of self-referred patients, as compared with those referred by EMS. Therefore, we described self-referral patients enrolled in the CPU-registry of the German Cardiac Society and compared them with those referred by EMS. Methods and results: From 2008 until 2010, the prospective CPU-registry enrolled 11,581 consecutive patients. Of those 3789 (32.7%) were self-referrals (SRs), while 7792 (67.3%) were referred by EMS. SR-patients were significantly younger (63.6 vs. 70.1 years), had less prior myocardial infarction or coronary artery bypass surgery, but more previous percutaneous coronary interventions (PCIs). Acute coronary syndromes were diagnosed less frequently in the SRpatients (30.3 vs. 46.9%; p<0.0001). SR-patients showed ST-segment changes in their initial ECG in 19.6% of cases. EMSpatients underwent more coronary angiographies (60.0 vs. 47.5%; p<0.0001), while SR-patients underwent more stress tests (11.3 vs. 7.8%; p<0.001). PCI was performed in 32.6% of the EMS-and in 24.0% of the SR-group (p<0.0001).Conclusion: These data demonstrate that patients who contact a CPU as a self-referral are younger, less severely ill and have more non-coronary problems than those calling an emergency medical service. Nevertheless, 30% of self-referral patients had an acute coronary syndrome.

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Patients with acute myocardial infarction using ambulance or private transport to reach definitive care: which mode is quicker?

Abstract: Although private transportation results in a faster trip to the hospital, quicker definitive care is obtained with the use of ambulance.

Cited by 14 publications

References 21 publications

Epidemiological Profile of Hispanics Admitted With Acute Myocardial Infarction in Puerto Rico: The Experience of 2007, 2009 and 2011

Epidemiological Profile of Hispanics Admitted With Acute Myocardial Infarction in Puerto Rico: The Experience of 2007, 2009 and 2011

Use of Emergency Medical Service Transport Among Patients With ST-Segment–Elevation Myocardial Infarction

Self-referral to chest pain units: results of the German CPU-registry

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