title: [Prehospital management of very elderly patients with ST segment elevation in Paris by mobile intensive care units (Samu)].
abstract: More and more elderly people are hospitalised with myocardial infarction. Little is known on their pre-hospital management. In 2001 and 2002, 105 patients aged 80 years or more with suspected ST elevation infarction were managed by the mobile intensive care unit system of the SAMU de Paris-Necker. Diagnosis of infarction was confirmed in 92 (88%). Over 60% of the patients were women. Median time delay from symptom onset to call to the emergency service was 127 minutes, longer in nonagenarians (175 vs 101 minutes). Prehospital use of aspirin was 81% and 39% received an intravenous bolus of heparin. A reperfusion strategy was decided in only 30% (primary PCI: 23/26). One-month mortality was 21% and was related to older age, time when the call to the Samu was made, and absence of current smoking. Overall, the prehospital management of very elderly patients with suspected ST elevation infarction appears far from optimal.
authors.affiliation: Samu de Paris, hôpital Necker, Paris, France.
authors.forename: J E
authors.initials: JE
authors.lastname: Leroy
authors.forename: C
authors.initials: C
authors.lastname: Bensouda
authors.forename: E
authors.initials: E
authors.lastname: Durand
authors.forename: A
authors.initials: A
authors.lastname: Greffet
authors.forename: A
authors.initials: A
authors.lastname: Scemama
authors.forename: P
authors.initials: P
authors.lastname: Carli
authors.forename: N
authors.initials: N
authors.lastname: Danchin
authors.forename: P
authors.initials: P
authors.lastname: Sauval
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003627:Data Interpretation, Statistical; D004562:Electrocardiography; D004632:Emergency Medical Services; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D010297:Paris; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D001241:Aspirin