Document Detail


Delays in presentation with acute coronary syndrome in people with coronary artery disease in Australia and New Zealand.
MedLine Citation:
PMID:  21489162     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objectives: To report time from the onset of symptoms to hospital presentation in Australian and New Zealand patients with subsequently confirmed acute coronary syndrome, and to identify factors associated with prehospital delay time in these patients. Methods: Patients with coronary artery disease enrolled in a randomized clinical trial testing an intervention to reduce delay in responding to acute coronary syndrome symptoms had been followed for 24 months. In cases of admission to the ED for possible acute coronary syndrome, medical records were reviewed to determine the diagnosis, prehospital delay time, mode of transport to the hospital and aspirin use before admission. Clinical and demographic data were taken from the trial database. Results: Patients (n= 140) had an average (SD) age of 67.3 (11.5) years; 36% were female. Two-thirds of patients went to hospital by ambulance and 89.3% had a final diagnosis of unstable angina. The median time from onset of symptoms to arrival at the ED was 2 h and 25 min (interquartile range 1:25-4:59); 12.1% arrived ≤ 1 h and 66% within 4 h. Multiple linear regression analysis showed that use of ambulance (Beta = 0.247, P= 0.012) and younger age (Beta = 0.198, P= 0.043) were independent predictors of shorter delay times. Conclusion: The time from the onset of symptoms to hospital presentation was too long for maximal benefit from treatment in most patients. Further efforts are needed to reduce treatment-seeking delay in response to symptoms of acute coronary syndrome.
Authors:
Sharon McKinley; Leanne M Aitken; Andrea P Marshall; Thomas Buckley; Heather Baker; Patricia M Davidson; Kathleen Dracup
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-10
Journal Detail:
Title:  Emergency medicine Australasia : EMA     Volume:  23     ISSN:  1742-6723     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101199824     Medline TA:  Emerg Med Australas     Country:  -    
Other Details:
Languages:  ENG     Pagination:  153-161     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Affiliation:
Northern Sydney Central Coast Health, Critical Care Nursing Professorial Unit Midwifery and Health, Faculty of Nursing, University of Technology Sydney Sydney Nursing School, University of Sydney School of Nursing and Midwifery, Curtin University of Technology, Sydney, New South Wales Griffith University & Nursing Practice Development Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia The University of Auckland, School of Nursing, Auckland, New Zealand; and School of Nursing, University of California, San Francisco, California, USA.
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