Shahbazpour Jafar, Abbasi Mohammad, Eskandari Narges, Aghaali Mohammad, Norouzadeh Reza
Department of Medical Surgical Nursing, School of Nursing, Qom University of Medical Sciences, Qom, Iran.
Department of Nursing, School of Nursing, Qom University of Medical Sciences, Qom, Iran.
J Educ Health Promot. 2022 Mar 23;11:95. doi: 10.4103/jehp.jehp_810_21. eCollection 2022.
Delay in seeking medical help in patients with acute myocardial infarction (AMI) challenges the patients in terms of diagnosis and treatment. This study aimed to evaluate the outcomes of delay referral (≥12 h) in patients with AMI.
In this retrospective cohort study, the medical records of 252 patients with AMI (2017-2019) admitted to Shahid Beheshti Hospital, Qom, Iran, was reviewed. Data collection tool was a researcher-made data sheet that included demographic characteristics, times, hospitalization costs, risk factors, history of heart disease, results of paraclinical tests, clinical information at the time of admission, and outcomes of delayed referral. Data were analyzed using -test, Chi-square, Kaplan-Meier estimator, log-rank test, Cox regression by STATA, and SPSS (version 25).
The levels of troponin, creatine phosphokinase, lactate dehydrogenase were significantly higher in the delayed referral group ( < 0.05). After treatment, the cardiac ejection fraction was significantly different in the nondelayed referral (41.56 ± 9.16) and the delayed referral group (38.39 ± 11.01) ( < 0.001). There was no significant difference in the percentage of hospital deaths in the groups ( = 0.078).
Delayed referral of patients with AMI is associated with decreased physiological cardiac function, which complicates recovery for these patients.
急性心肌梗死（AMI）患者寻求医疗帮助的延迟在诊断和治疗方面给患者带来了挑战。本研究旨在评估AMI患者延迟转诊（≥12小时）的结果。
在这项回顾性队列研究中，回顾了2017年至2019年入住伊朗库姆市沙希德·贝赫什提医院的252例AMI患者的病历。数据收集工具是研究者制作的数据表，其中包括人口统计学特征、时间、住院费用、危险因素、心脏病史、辅助检查结果、入院时的临床信息以及延迟转诊的结果。使用t检验、卡方检验、Kaplan-Meier估计器、对数秩检验、STATA软件进行的Cox回归以及SPSS（版本25）对数据进行分析。
延迟转诊组的肌钙蛋白、肌酸磷酸激酶、乳酸脱氢酶水平显著更高（P<0.05）。治疗后，非延迟转诊组（41.56±9.16）和延迟转诊组（38.39±11.01）的心脏射血分数有显著差异（P<0.001）。两组的医院死亡百分比无显著差异（P = 0.078）。
AMI患者的延迟转诊与心脏生理功能下降有关，这使这些患者的康复复杂化。
