Vavouranakis Ioannis, Fanioudaki Anthi, Lamprogiannakis Emmanuel, Baltzakis Ioannis, Sidiropoulou Kalliopi, Porfiri Eleni, Ganotakis Emmanuel S
Heraklion Medical Society, School of Nursing, Technological Educational Institute, Heraklion, Crete, Greece.
Rural Remote Health. 2010 Apr-Jun;10(2):1271. Epub 2010 May 28.
Treatment delay during myocardial infarction may be due to a number of factors, such as age, sex, socioeconomic status and interpretation of symptoms. However, whether residence plays a role has not been fully investigated and, if known, could provide information that will help target specific populations. This study investigated whether urban and rural residents in Greece differ in the time required to seek and receive medical assistance during acute myocardial infarction, according to their characteristics and the determinants of their delay.
This was an observational study (with a structured interview) conducted in one academic and one regional hospital on the island of Crete, Greece, consisting of 348 patients with confirmed myocardial infarction.
Patients from rural and urban areas did not differ in the decision time before seeking medical assistance (180 min vs 240 min, p=0.058). Those living in rural areas experienced a longer delay in reaching hospital once they sought assistance (50 min vs 20 min, p<0.0001). The total median delay time (4.25 hours for rural and 4.75 hours for urban patients, p=0.9) was positively affected by female sex and negatively affected by a patient's belief that symptoms were serious, and that they were heart-related.
Strategies should be developed to reduce the treatment delay during myocardial infarction for residents of both urban and rural areas, especially for women. Patients interpreting symptoms as being serious and originating from the heart are important for a shorter delay. A better health system is needed in rural Greece in order to deal more effectively with medical emergencies such as myocardial infarction.
心肌梗死治疗延迟可能由多种因素导致，如年龄、性别、社会经济地位以及对症状的解读。然而，居住地是否起作用尚未得到充分研究，若有相关信息，可为针对特定人群提供帮助。本研究调查了希腊城乡居民在急性心肌梗死期间寻求和获得医疗救助所需时间是否存在差异，依据其特征及延迟的决定因素进行分析。
这是一项在希腊克里特岛的一家学术医院和一家地区医院进行的观察性研究（采用结构化访谈），共纳入348例确诊心肌梗死患者。
城乡患者在寻求医疗救助前的决策时间并无差异（180分钟对240分钟，p = 0.058）。但农村居民在寻求救助后到达医院的延迟时间更长（50分钟对20分钟，p < 0.0001）。总中位延迟时间（农村患者为4.25小时，城市患者为4.75小时，p = 0.9）受女性性别影响呈正向变化，受患者认为症状严重及与心脏有关的信念影响呈负向变化。
应制定策略以减少城乡居民心肌梗死治疗延迟，尤其是女性。将症状解读为严重且源于心脏的患者对于缩短延迟时间很重要。希腊农村地区需要更好的卫生系统，以便更有效地应对心肌梗死等医疗紧急情况。
