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KMID : 0882420160900060507
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Korean Journal of Medicine
2016 Volume.90 No. 6 p.507 ~ p.513
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Emergency Medical Service Use among Patients with Acute ST-segment Elevation Myocardial Infarction in Jeonbuk Province
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Woo Sun-Ho
Yun Kyeong-Ho
Lee Mi-Rim
Kim Eun-Kyoung
Ko Jum-Suk
Rhee Sang-Jae
Lee Jeong-Mi
Kim Nam-Ho
Oh Seok-Kyu
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Abstract
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Background/Aims: The use of emergency medical services (EMSs) at the onset of pain, and the relationship between transport type and the treatment delay for acute ST-segment elevation myocardial infarction (STEMI) were evaluated using the Jeonbuk Regional Cardiovascular Center database.
Methods: In total, 527 STEMI patients who underwent primary percutaneous coronary intervention (PCI) were enrolled in this study. Basic characteristics, socioeconomic variables, and delay factors were compared between patients that contacted an EMS as first medical contact (FMC) and patients that used other forms of FMC.
Results: Only 28.8% of patients used EMS as their FMC. The patients that used EMS showed significantly shorter onset-to-balloon time than those who did not (250.7 ± 366.6 min vs. 405.9 ± 649.8 min, p = 0.001). However, 36.2% of patients that used EMS as FMC were transported to non-PCI-capable centers, which led to significantly prolonged onset-to-balloon time. Multivariate analysis revealed that transfer via another hospital (odds ratio [OR] 2.0, p < 0.001), EMS as FMC (OR 0.4, p < 0.001), age > 65 years (OR 1.9, p = 0.003), and previous history of PCI (OR 0.4, p = 0.033) were independent predictors of pre-hospital delay.
Conclusions: EMS used as FMC at the onset of chest pain was an important factor for decreasing treatment delay in patients with STEMI. However, a small number of patients used EMS as FMC, and some patients that used EMS were transported to non-PCI-capable centers. Public campaigns and education are needed to raise the public awareness of STEMI and the use of EMSs.
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KEYWORD
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Myocardial infarction, Emergency medical services, Time factors
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