Characteristics of patients with acute myocardial infarction contacting primary healthcare before hospitalisation: a cross-sectional study.

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  • Additional Information
    • Corporate Authors:
      SymTime Study Group
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100967792 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2296 (Electronic) Linking ISSN: 14712296 NLM ISO Abbreviation: BMC Fam Pract Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2000-2021]
    • Subject Terms:
      Decision Making* ; Emergency Medical Services* ; Health Behavior* ; Hospitalization* ; Myocardial Infarction* ; Primary Health Care*; Aged ; Chest Pain ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Pain Measurement ; Patient Acceptance of Health Care ; ST Elevation Myocardial Infarction ; Sweating ; Sweden ; Time Factors ; Time-to-Treatment
    • Abstract:
      Background: The characteristics of patients with on-going myocardial infarction (MI) contacting the primary healthcare (PHC) centre before hospitalisation are not well known. Prompt diagnosis is crucial in patients with MI, but many patients delay seeking medical care. The aims of this study was to 1) describe background characteristics, symptoms, actions and delay times in patients contacting the PHC before hospitalisation when falling ill with an acute MI, 2) compare those patients with acute MI patients not contacting the PHC, and 3) explore factors associated with a PHC contact in acute MI patients.
      Methods: This was a cross-sectional multicentre study, enrolling consecutive patients with MI within 24 hours of admission to hospital from Nov 2012 until Feb 2014.
      Results: A total of 688 patients with MI, 519 men and 169 women, were included; the mean age was 66±11 years. One in five people contacted PHC instead of the recommended emergency medical services (EMS), and 94% of these patients experienced cardinal symptoms of an acute MI; i.e., chest pain, and/or radiating pain in the arms, and/or cold sweat. Median delay time from symptom-onset-to-decision-to-seek-care was 2:15 hours in PHC patients and 0:40 hours in non-PHC patients (p<0.01). The probability of utilising the PHC before hospitalisation was associated with fluctuating symptoms (OR 1.74), pain intensity (OR 0.90) symptoms during off-hours (OR 0.42), study hospital (OR 3.49 and 2.52, respectively, for two of the county hospitals) and a final STEMI diagnosis (OR 0.58).
      Conclusions: Ambulance services are still underutilized in acute MI patients. A substantial part of the patients contacts their primary healthcare centre before they are diagnosed with MI, although experiencing cardinal symptoms such as chest pain. There is need for better knowledge in the population about symptoms of MI and adequate pathways to qualified care. Knowledge and awareness amongst primary healthcare professionals on the occurrence of MI patients is imperative.
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    • Contributed Indexing:
      Keywords: Chest pain; Myocardial infarction; Pre-hospital delay; Primary healthcare
    • Publication Date:
      Date Created: 20181012 Date Completed: 20190911 Latest Revision: 20190911
    • Publication Date:
      20240104
    • Accession Number:
      PMC6180517
    • Accession Number:
      10.1186/s12875-018-0849-8
    • Accession Number:
      30305077