[Thrombolytic delay in myocardial infarction and primary care].
OBJECTIVE
To analyse the effect of a primary care consultation at a health centre or at home and to determine the effect of the use of the pre-hospital electrocardiogram on thrombolytic delay.


METHODS
Analytical cross-sectional study.


METHODS
La Safor county (136,000 inhabitants), Valencia, Spain.


METHODS
Sample of 137 patients from the area admitted for acute myocardial infarction.


METHODS
None.


RESULTS
Multivariate analysis through Cox regression models of the thrombolytic delay, comparing the patients who attended a primary care centre (40, 29.2%) and those who called out a doctor to their home (26, 19.0%) with those who attended hospital (71, 51.8%). The thrombolysis proportions in the groups were analysed with logistic regression. Patients referred from primary care arrived at hospital later than those who attended directly, although a greater thrombolytic delay was only seen in those visited at home (RR 0.25, 95% CI 0.09-0.71). A primary care electrocardiogram (14 patients, 10.2%) reduced the thrombolytic delay (RR 8.81, 95% CI 1.20-64.91) by reducing intra-hospital delay. There were no differences between the groups for the thrombolysis proportion (67 patients, 48.9%).


CONCLUSIONS
Patients with infarction seen in primary care reach hospital later. Calling and waiting for the doctor at home increases the thrombolytic delay. An electrocardiogram on the infarction patients who attend a health centre reduces thrombolytic delay by reducing intra-hospital delay.
Soler Torró
J M
JM
Servicio de Urgencias, Hospital Francesc de Borja, Gandía, Valencia. jmsoler@meditex.es
Martín Baena
J C
JC
Amer Llueca
G
G
Chova Morant
S
S
Martín Clós
J
J
Orengo Faus
V
V
D000368:Aged; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D004562:Electrocardiography; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy*; D011320:Primary Health Care; D015912:Thrombolytic Therapy; D013997:Time Factors