Prehospital system delay in patients with ST-segment elevation myocardial infarction in Singapore

Ho, Andrew Fu Wah; Pek, Pin Pin; Fook‐Chong, Stephanie; Wong, Ting Hway; Ng, Yih Yng; Wong, Aaron; Ong, Marcus Eng Hock

doi:10.5847/wjem.j.1920-8642.2015.04.005

Cited by 9 publications

(23 citation statements)

References 17 publications

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“…In others, FMC was the time the ECG was performed by the EMS [18, 19, 20]. Moreover, other studies used the time of the patient’s phone call to the EMS as FMC [21]. Using the time patients called the ambulance as FMC may be unreliable because that phone call would be the only way to assess the patient’s condition.…”

Section: Discussionmentioning

confidence: 99%

The effects of prehospital system delays on the treatment efficacy of STEMI patients

Żurowska-Wolak

Piekos

Jąkała

et al. 2019

Scand J Trauma Resusc Emerg Med

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Background Cardiovascular disease accounts for nearly half of all deaths in Poland . The aim of this study was to assess both the duration and the delays of prehospital treatment in ST-segment elevation myocardial infarction (STEMI) patients and how it impacts left ventricle ejection fraction (LVEF) measured at the time of discharge and the frequency of in-hospital patient mortality. Methods This study retrospectively analyzed medical records from January 2011 to December 2015 (excluding the year 2013) of 573 patients who were transported to a hospital with a diagnosis of STEMI. Results The mean time of prehospital system delays was 59 min with a maximum time of 152 min and a minimum time of 23 min. The relationship between reduced LVEF (< 55%) and in-hospital patient mortality and the relationship between length of time from first medical contact (FMC) to hospital admission was analysed in 515 respondents. Extending the time of FMC to hospital admission by 1 min increased the chances of lowering LVEF by 2% (95% CI: 1.004–1.041) and increased the chances of death by 2% (95% CI: 1.002–1.04) in STEMI patients. Conclusions This study emphasised how vital it is to minimise time spent with STEMI patients at the scene of their cardiovascular event by performing an ECG as quickly as possible and by immediately transporting the patient to the hospital with the targeted treatment. This may lead to the implementation of additional training in the field of ECG interpretation, increase the prevalence of teletransmission systems, and improve communication between Emergency Medical Services (EMS) and catheterization laboratories ultimately reducing patient mortality.

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Section: Discussionmentioning

confidence: 99%

The effects of prehospital system delays on the treatment efficacy of STEMI patients

Żurowska-Wolak

Piekos

Jąkała

et al. 2019

Scand J Trauma Resusc Emerg Med

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“…Treatment time delay is caused by various delays between symptom onset and reperfusion therapy. [ 5 , 6 ] “Patient delay” is defined as the time from symptom onset to the patient's seeking medical attention, that is, the first medical contact. [ 5 , 6 ] “System delay” is the time interval between the first medical contact and reperfusion.…”

Section: Introductionmentioning

confidence: 99%

“…[ 5 , 6 ] “Patient delay” is defined as the time from symptom onset to the patient's seeking medical attention, that is, the first medical contact. [ 5 , 6 ] “System delay” is the time interval between the first medical contact and reperfusion. [ 5 , 6 ] Finally, “total treatment delay” is defined as the sum of the patient delay and the system delay.…”

Section: Introductionmentioning

confidence: 99%

“…[ 5 , 6 ] “System delay” is the time interval between the first medical contact and reperfusion. [ 5 , 6 ] Finally, “total treatment delay” is defined as the sum of the patient delay and the system delay. [ 5 , 6 ] Since patient delay accounts for most of the prehospital delay [ 7 ] and total treatment delay is important for improving clinical outcomes in STEMI, [ 8 ] both are good indicators to investigate the association between symptoms and the treatment time delay.…”

Section: Introductionmentioning

confidence: 99%

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Symptom clusters and treatment time delay in Korean patients with ST-elevation myocardial infarction on admission

et al. 2018

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Most patients with acute myocardial infarction (AMI) experience more than one symptom at onset. Although symptoms are an important early indicator, patients and physicians may have difficulty interpreting symptoms and detecting AMI at an early stage. This study aimed to identify symptom clusters among Korean patients with ST-elevation myocardial infarction (STEMI), to examine the relationship between symptom clusters and patient-related variables, and to investigate the influence of symptom clusters on treatment time delay (decision time [DT], onset-to-balloon time [OTB]). This was a prospective multicenter study with a descriptive design that used face-to-face interviews. A total of 342 patients with STEMI were included in this study. To identify symptom clusters, two-step cluster analysis was performed using SPSS software. Multinomial logistic regression to explore factors related to each cluster and multiple logistic regression to determine the effect of symptom clusters on treatment time delay were conducted. Three symptom clusters were identified: cluster 1 (classic MI; characterized by chest pain); cluster 2 (stress symptoms; sweating and chest pain); and cluster 3 (multiple symptoms; dizziness, sweating, chest pain, weakness, and dyspnea). Compared with patients in clusters 2 and 3, those in cluster 1 were more likely to have diabetes or prior MI. Patients in clusters 2 and 3, who predominantly showed other symptoms in addition to chest pain, had a significantly shorter DT and OTB than those in cluster 1. In conclusion, to decrease treatment time delay, it seems important that patients and clinicians recognize symptom clusters, rather than relying on chest pain alone. Further research is necessary to translate our findings into clinical practice and to improve patient education and public education campaigns.

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“…And a study by Cho et al [26] reported that high Hb and NLR values were associated with signifi cant mortality in coronary artery diseases when evaluated together. Boles et al [27] reviewed the development of coronary artery ectasia and short term prognosis. In AMI patients developing coronary artery ectasia, NLR values were identified to be lower compared to AMI patients not developing ectasia and also inflammatory response between the patients with developing and not developing coronary artery ectasia were reported to be different but this was indicated to have no prognostic value.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio in occlusive vascular diseases: the literature review of the past 10 years

Küçük¹,

Kocayiğit²,

Günel³

et al. 2016

World Journal of Emergency Medicine

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Prehospital system delay in patients with ST-segment elevation myocardial infarction in Singapore

Abstract: Prehospital system delay in our patients was suboptimal. This is the first attempt at characterizing prehospital system delay in Singapore and forms the basis for improving efficiency of STEMI care.

Cited by 9 publications

References 17 publications

The effects of prehospital system delays on the treatment efficacy of STEMI patients

The effects of prehospital system delays on the treatment efficacy of STEMI patients

Symptom clusters and treatment time delay in Korean patients with ST-elevation myocardial infarction on admission

Neutrophil-to-lymphocyte ratio in occlusive vascular diseases: the literature review of the past 10 years

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