Ambulance use in patients with acute myocardial infarction.
OBJECTIVE
To explore the choice of transportation mode to hospital in patients experiencing acute myocardial infarction.


METHODS
A descriptive survey study at the Coronary Care Unit of one Swedish University Hospital. The study was carried out between July 2000 and March 2001.


RESULTS
The study population consisted of 114 consecutive patients with acute myocardial infarction. Thirty-two percent stated that they did not know the importance of a short delay when experiencing an acute myocardial infarction. Only 60% called the emergency service number, 112. Patients calling for an ambulance differed from those who did not in several aspects. Medical characteristics associated with ambulance use in a univariate analysis were ST-elevation myocardial infarction and prior history of myocardial infarction. There were no differences regarding gender or age. When looking at the patients' symptom-experience, patients with vertigo or nausea and severe pain chose an ambulance for transport to the hospital. The only significant reasons for not choosing an ambulance were cramping pain and the patient perceiving the symptoms not to be serious. In a multivariate analysis, ST-elevation (OR = 0.30, P = .04), unbearable symptoms (OR = 0.20, P = .03), and nausea (OR = .33, P = .04) appeared as independent predictors of ambulance use and cramping pain (OR = 5.17, P = .01) for not using an ambulance.


CONCLUSIONS
Patients with acute myocardial infarction view the ambulance as an option for transportation to hospital only if they feel really sick. For that reason, it needs to be made well known to the public that ambulances are not only a mode of transport, but also provide diagnostics and treatment.
Department of Cardiology, University Hospital, Linköping, Sweden. ingela.johansson@lio.se
Ingela
I
Johansson
Anna
A
Strömberg
Eva
E
Swahn
D000368:Aged; D000552:Ambulances / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D002637:Chest Pain / Q000209:etiology; D002755:Choice Behavior; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000523:psychology* / Q000628:therapy; D009325:Nausea / Q000209:etiology; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012008:Recurrence; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014187:Transportation of Patients / Q000379:methods*