Prehospital delay and its impact on time to treatment in ST-elevation myocardial infarction

• Published in: The American journal of emergency medicine Vol. 29; no. 4; pp. 396 - 400
• Main Authors: Chughtai, Haroon, MD, Ratner, Douglas, MD, Pozo, Mario, Crouchman, Joseph A, Niedz, Barbara, PhD, Merwin, Richard, MD, Lahita, Robert G., MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-05-2011; Elsevier; Elsevier Limited
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Angioplasty, Balloon, Coronary; Biological and medical sciences; Cardiology. Vascular system; Cohort Studies; Coronary heart disease; Electrocardiography; Emergency; Emergency medical care; Emergency Medical Services - organization & administration; Female; Heart; Heart attacks; Hospitals; Humans; Intensive care medicine; Intubation; Ischemia; Male; Medical sciences; Middle Aged; Mortality; Myocardial infarction; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Retrospective Studies; Studies; Survival Rate; Time Factors; Myocardial infarction; ST elevation; Intensive care; Treatment; Cardiovascular disease; Delay time; Coronary heart disease; Myocardial disease; Resuscitation; Delayed time
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2009.11.006

Abstract Purposes We performed this study to assess the impact of pre-hospital time on the patient’s outcome. Procedures Starting from the symptoms onset, “total time to treatment” was divided into less than or equal to 120 minutes and more than 120 minutes (“pre-hospital time” of ≤ or > 30 minutes respectively). Adverse patient’s outcomes were compared in the two subgroups. Findings Our patients had a mean age of 63 (±13) years. On-scene time (17.8 ± 9.4 minutes), was the biggest fraction of “pre-hospital time”. Comparing the groups with “Total time to treatment” of >120 minutes vs. ±120 minutes (“pre-hospital time” of >30 vs. ≤30 minutes), mortalities were 4 vs. 0 and transfers to a tertiary care facility were 3 vs.1. Conclusions Most of the pre-hospital time in STEMI was spent on the scene and we suggest “total time to treatment” as a core measure instead of “door to balloon time”.