Leitch J W, Birbara T, Freedman B, Wilcox I, Harris P J
Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW.
Med J Aust. 1989 Jan 2;150(1):6-10. doi: 10.5694/j.1326-5377.1989.tb136310.x.
One hundred patients who were admitted to a coronary-care unit were interviewed to determine the time interval from the onset of chest pain to their arrival at the Emergency Department of Royal Prince Alfred Hospital. Forty-nine per cent of patients took longer than two hours and 29% took longer than four hours to arrive at hospital; the patient who reported the longest time interval reached hospital 72 h after the onset of chest pain. Most of the delay between the onset of symptoms and arrival at hospital was a result of the time that the patients took to decide to seek medical attention. Once this decision was made, there was relatively-little delay before hospital presentation in patients who went directly to hospital. However, those patients who contacted a doctor rather than going directly to hospital took significantly longer to arrive at hospital, with a median total time to reach hospital of 212 min compared with 85 min for those who went directly to hospital (P = 0.002). Time delays of this magnitude compromise the efficacy of interventions such as thrombolytic therapy. There should be continuing public education to encourage patients with chest pain to seek early medical attention and, in metropolitan areas, patients with chest pain should be advised to proceed directly to hospital.
对入住冠心病监护病房的100名患者进行了访谈，以确定从胸痛发作到他们抵达皇家阿尔弗雷德王子医院急诊科的时间间隔。49%的患者花费超过两小时，29%的患者花费超过四小时才抵达医院；报告最长时间间隔的患者在胸痛发作72小时后才抵达医院。症状发作到抵达医院之间的大部分延迟是由于患者决定寻求医疗帮助所花费的时间。一旦做出这一决定，直接前往医院的患者在就诊前的延迟相对较小。然而，那些联系医生而不是直接前往医院的患者抵达医院的时间明显更长，抵达医院的总时间中位数为212分钟，而直接前往医院的患者为85分钟（P = 0.002）。如此程度的时间延迟会影响溶栓治疗等干预措施的疗效。应持续开展公众教育，鼓励胸痛患者尽早寻求医疗帮助，在大都市地区，应建议胸痛患者直接前往医院。
