Meischke H, Eisenberg M S, Larsen M P
Center for Evaluation of Emergency Medical Services, Seattle-King County Department of Public Health, Washington.
Ann Emerg Med. 1993 Oct;22(10):1597-601. doi: 10.1016/s0196-0644(05)81267-3.
To investigate the effect of heart-related medical conditions and demographic variables on patients' tendency to delay contacting emergency medical services for symptoms of acute myocardial infarction.
A sample of 2,947 patients with acute myocardial infarction but no cardiac arrest, transported by paramedics to the coronary care units of 19 hospitals in King County, Washington, between January 1988 and April 1991.
Patient record abstracts contained information on medical history, age, gender, delay interval, and means of transportation.
Multiple regression analyses showed that prehospital delay interval was significantly greater for individuals who were older and female and who had a history of angina, congestive heart failure, or diabetes.
It is important to investigate further how people interpret and evaluate their symptoms in light of other medical conditions. It is also critical to find out why women delay longer than men and why older individuals delay longer than younger people before they contact emergency medical services. Interventions need to be developed that are targeted at populations at risk for delaying use of emergency medical services for acute myocardial infarction symptoms. These interventions must legitimize the use of emergency medical services and encourage patients to act quickly when confronted with acute myocardial infarction symptoms.
调查与心脏相关的医疗状况和人口统计学变量对患者因急性心肌梗死症状而延迟联系紧急医疗服务的倾向的影响。
1988年1月至1991年4月期间，由护理人员送往华盛顿州金县19家医院冠心病监护病房的2947例急性心肌梗死但无心脏骤停的患者样本。
患者病历摘要包含病史、年龄、性别、延迟时间间隔和交通方式等信息。
多元回归分析显示，年龄较大、女性以及有心绞痛、充血性心力衰竭或糖尿病病史的个体，院前延迟时间间隔显著更长。
进一步研究人们如何根据其他医疗状况来解释和评估自身症状非常重要。找出女性比男性延迟时间更长以及老年人比年轻人在联系紧急医疗服务之前延迟时间更长的原因也至关重要。需要制定针对因急性心肌梗死症状而延迟使用紧急医疗服务风险人群的干预措施。这些干预措施必须使紧急医疗服务的使用合法化，并鼓励患者在出现急性心肌梗死症状时迅速行动。
