Bleeker J K, Erdman R A, Lamers L M, van der Does E, Simoons M L
GGD, afd. Epidemiologie, Rotterdam.
Ned Tijdschr Geneeskd. 1993 Oct 9;137(41):2082-6.
Timely treatment of patients with an evolving myocardial infarction improves the short and long term prognoses. Because of a wrong judgement of the situation by the patient, a significant other or by a general practitioner (GP), treatment may be delayed. To examine this delay 300 patients with myocardial infarction took part in a study between March 1990 and October 1991. After written consent was given, they were interviewed about the pre-hospital period. The significant others received a questionnaire about this period. Medical information was collected from the cardiologists. Fifty percent of all patients called for medical help within 30 minutes. The GP arrived within 11 minutes at the patient's place in 50% of all cases. However, in 50% of all cases the decision making of the GPs before the patient was sent to a hospital required more than 82 minutes. The ambulance arrived within 15 minutes at the patient's place in 90% of all cases. Stabilisation of the patient by the ambulance staff and transport to the hospital took slightly more time. Compared with earlier studies, the patient with a possible myocardial infarction calls for help sooner. Subsequently, in many cases it takes considerable time before the GP refers the patient to a hospital. Further research is needed to improve the diagnostic power of the GP.
及时治疗正在发展的心肌梗死患者可改善短期和长期预后。由于患者本人、重要他人或全科医生（GP）对病情判断错误，治疗可能会延迟。为研究这种延迟情况，1990年3月至1991年10月期间，300名心肌梗死患者参与了一项研究。在获得书面同意后，他们接受了关于院前阶段的访谈。重要他人收到了关于这一阶段的问卷。从心脏病专家那里收集了医疗信息。所有患者中有50%在30分钟内呼叫了医疗救助。在所有病例的50%中，全科医生在11分钟内到达患者处。然而，在所有病例的50%中，全科医生在将患者送往医院之前的决策时间需要超过82分钟。在所有病例的90%中，救护车在15分钟内到达患者处。救护人员对患者进行稳定处理并送往医院花费的时间稍长一些。与早期研究相比，可能患有心肌梗死的患者更早呼叫救助。随后，在许多情况下，全科医生将患者转诊至医院需要相当长的时间。需要进一步研究以提高全科医生的诊断能力。
