Characteristics associated with the patient delay during the management of ST-elevated myocardial infarction, and the influence of awareness campaigns - 09/01/21
Résumé |
Background |
The patient delay between the occurrence of symptoms and call for seeking medical assistance is an important component of the pain-to-balloon delay in patients with ST-elevated myocardial infarction (STEMI). Factors affecting this delay have been poorly studied, and awareness campaigns regarding the emergency call have barely been evaluated. We evaluated the factors related to the patient delay and the effects of public awareness campaigns undertaken in our region.
Methods |
Data from the regional registry of STEMI in Limousin, France, were analyzed and we performed a survey to assess medical history, clinical signs, context, socio-economic situation, perception and behavior of the patient. “Late callers” (i.e. 3rd tertile, >154min) were compared to “early callers” (i.e. first and 2nd tertile, ≤154min) using univariate and multivariate statistical methods. The influence of public awareness campaigns was studied by comparing the delays before and after a regional campaign.
Results |
Among 481 patients, the median patient delay was 87min. “Late callers” were older (OR=1.02 per year, 95%CI=[1.00–1.12]), had more often symptoms onset between 00:00 and 05:59am (OR=1.86, [1.10–3.12]), seeked more often general practitioners’ assistance (OR=2.58, [1.66–4.04]) or attended the emergency room (OR=4.10, [2.04-8.32]). Sweats and the feeling of a severe situation were associated with a reduced delay. After awareness campaigns, there was no change in the patient's delay but the proportion of patients calling Emergency Medical Service increased from 55% to 62% (P<0.001).
Conclusions |
The patient delay is multifactorial. The impact of previous campaigns is mixed. Psychological and behavioral aspects are determinant and should be taken into consideration for targeted awareness messages to specific groups.
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Vol 13 - N° 1
P. 153 - janvier 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.