Nguyen Hoa L, Saczynski Jane S, Gore Joel M, Goldberg Robert J
Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA.
Circ Cardiovasc Qual Outcomes. 2010 Jan;3(1):82-92. doi: 10.1161/CIRCOUTCOMES.109.884361. Epub 2009 Nov 24.
Coronary heart disease is the leading cause of morbidity and mortality in American men and women. Although there have been dramatic changes in the management of patients hospitalized with acute myocardial infarction (AMI) over the past several decades, a considerable proportion of patients with AMI continue to delay seeking medical care in a timely manner. This review provides an overview of the published literature that has examined age and sex differences in extent of prehospital delay in patients hospitalized with AMI.
A systematic review of the literature from 1960 to 2008, including publications that provided data on duration of prehospital delay in patients hospitalized with AMI, was conducted. A total of 44 articles (42 studies) were included in the present analysis. The majority of studies showed that in patients hospitalized with AMI, women and older persons were more likely to arrive at the hospital later than men and younger persons. Several factors associated with duration of prehospital delay, including sociodemographic, medical history, clinical, and contextual characteristics differed according to sex.
The elderly and women were more likely to exhibit longer delays in seeking medical care after the development of symptoms suggestive of AMI compared with other groups. Further research is needed to more fully understand the reasons for delay in these vulnerable groups.
冠心病是美国男性和女性发病和死亡的主要原因。尽管在过去几十年中，急性心肌梗死（AMI）住院患者的管理发生了巨大变化，但仍有相当一部分AMI患者继续延迟及时就医。本综述概述了已发表的文献，这些文献研究了AMI住院患者院前延迟程度的年龄和性别差异。
对1960年至2008年的文献进行了系统综述，包括提供AMI住院患者院前延迟持续时间数据的出版物。本分析共纳入44篇文章（42项研究）。大多数研究表明，在AMI住院患者中，女性和老年人比男性和年轻人更晚到达医院。与院前延迟持续时间相关的几个因素，包括社会人口统计学、病史、临床和背景特征，因性别而异。
与其他群体相比，老年人和女性在出现提示AMI的症状后更有可能延迟就医。需要进一步研究以更全面地了解这些弱势群体延迟就医的原因。
