Dhungel Sachin, Malla Rabi, Adhikari Chandramani, Maskey Arun, Rajbhandari Rajeeb, Sharma Ranjit, Sharma Deewakar, Man Bhadhur K C, Adhikari Ajay, Rauniyar Binaya, Limbu Dipak, Gautam Milan
Department of Cardiology, College of Medical Science, Bharatpur, Chitwan, Nepal.
Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2017 Oct-Dec;56(208):421-5.
Pre-hospital delay includes time from onset of symptoms of myocardial infarction till arrival to emergency room of the hospital. This defines time from symptom onset to first medical contact and first medical contact to emergency room. This study aims to study the prehospital events and determining factors in patients undergoing primary angioplasty.
This was a cross sectional study in Shahid Gangalal National Heart Centre for three months. Timings of chest pain, first medical contact time, transfer time to hospital and overall pre-hospital time for PCI and risk factors were analysed.
There were 79 cases with 66 (83.5%) males and 13 (16.5%) females with mean age 56±11.2 years. Risk factors were 60 (75.9%), smoking, 47 (59.5%) hypertension, 25 (31.6%) diabetes, 22 (27.8%) dyslipidaemia and 16 (20.3%) heart failure. Chest pain was maximum in 5 to 9 AM. The median prehospital delay was 300 minutes (5.0 hours) of which symptom to first medical contact was 165 minutes and first medical contact to hospital was 80 minutes. The longer median prehospital delay for hypertension, diabetes, female and age ≥50 years and the shorter for male, age less than 50 years, dyslipidemia and heart failure, though not statistically significant. Private transport was the preferred from symptom to first medical contact and ambulance for first medical contact to emergency room. Patients received in ER had aspirin 72 (91.1%), atorvastatin 54 (68.4%) and double anti-platelets 45 (57%).
Chest pain was common in morning and the prehospital delay can be minimized by improving time from symptom to first medical contact and first medical contact to Emergency room.
院前延误包括从心肌梗死症状出现到抵达医院急诊室的时间。这界定了从症状出现到首次医疗接触以及从首次医疗接触到急诊室的时间。本研究旨在探讨接受直接血管成形术患者的院前事件及决定因素。
这是一项在沙希德·甘加拉尔国家心脏中心进行的为期三个月的横断面研究。分析了胸痛时间、首次医疗接触时间、转院至医院的时间以及PCI的总体院前时间和危险因素。
共有79例患者，其中男性66例（83.5%），女性13例（16.5%），平均年龄56±11.2岁。危险因素包括60例（75.9%）吸烟、47例（59.5%）高血压、25例（31.6%）糖尿病、22例（27.8%）血脂异常和16例（20.3%）心力衰竭。胸痛在上午5点至9点最为常见。院前延误的中位数为300分钟（5.0小时），其中从症状出现到首次医疗接触为165分钟，从首次医疗接触到医院为80分钟。高血压、糖尿病、女性以及年龄≥50岁的患者院前延误中位数较长，而男性、年龄小于50岁、血脂异常和心力衰竭患者的院前延误中位数较短，尽管差异无统计学意义。从症状出现到首次医疗接触时，患者更倾向于选择私人交通工具，而从首次医疗接触到急诊室则选择救护车。在急诊室接受治疗的患者中，72例（91.1%）服用了阿司匹林，54例（68.4%）服用了阿托伐他汀，45例（57%）接受了双联抗血小板治疗。
胸痛在早晨较为常见，通过缩短从症状出现到首次医疗接触以及从首次医疗接触到急诊室的时间，可将院前延误降至最低。
