title: Impact of a public campaign on pre-hospital delay in patients reporting chest pain.
abstract: OBJECTIVE
  To decrease pre-hospital delay in patients with chest pain.
  
  
  METHODS
  Population based, prospective observational study.
  
  
  METHODS
  A province of Switzerland with 380000 inhabitants.
  
  
  METHODS
  All 1337 patients who presented with chest pain to the emergency department of the Hôpital Cantonal Universitaire of Geneva during the 12 months of a multimedia public campaign, and the 1140 patients who came with similar symptoms during the 12 months before the campaign started.
  
  
  METHODS
  Pre-hospital time delay and number of patients admitted to the hospital for acute myocardial infarction (AMI) and unstable angina.
  
  
  RESULTS
  Mean pre-hospital delay decreased from 7h 50 min before the campaign to 4 h 54 min during it, and median delay from 180 min to 155 min (P < 0.001). For patients with a final diagnosis of AMI, mean delay decreased from 9 h 10 min to 5 h 10 min and median delay from 195 min to 155 min (P < 0.002). Emergency department visits per week for AMI and unstable angina increased from 11.2 before the campaign to 13.2 during it (P < 0.02), with an increase to 27 (P < 0.01) during the first week of the campaign; visits per week for non-cardiac chest pain increased from 7.6 to 8.1 (P = NS) during the campaign, with an increase to 17 (P < 0.05) during its first week.
  
  
  CONCLUSIONS
  Public campaigns may significantly reduce pre-hospital delay in patients with chest pain. Despite transient increases in emergency department visits for non-cardiac chest pain, such campaigns may significantly increase hospital visits for AMI and unstable angina and thus be cost effective.
authors.affiliation: Department of Medicine, Clinique de Médecine II, Hôpital Cantonal Universitaire, Geneva, Switzerland.
authors.forename: J M
authors.initials: JM
authors.lastname: Gaspoz
authors.forename: P F
authors.initials: PF
authors.lastname: Unger
authors.forename: P
authors.initials: P
authors.lastname: Urban
authors.forename: J C
authors.initials: JC
authors.lastname: Chevrolet
authors.forename: W
authors.initials: W
authors.lastname: Rutishauser
authors.forename: C
authors.initials: C
authors.lastname: Lovis
authors.forename: L
authors.initials: L
authors.lastname: Goldman
authors.forename: C
authors.initials: C
authors.lastname: Héliot
authors.forename: L
authors.initials: L
authors.lastname: Séchaud
authors.forename: S
authors.initials: S
authors.lastname: Mischler
authors.forename: F A
authors.initials: FA
authors.lastname: Waldvogel
mesh_terms: D000789:Angina, Unstable / Q000628:therapy; D002637:Chest Pain / Q000628:therapy*; D003365:Costs and Cost Analysis; D004630:Emergencies; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D011446:Prospective Studies; D013557:Switzerland; D013997:Time Factors