[Prehospital delay time and mortality in patients with acute myocardial infarction].
OBJECTIVE
To determine the relationship between prehospital delay time (PDT) and other associated factors on mortality in patients with acute myocardial infarction.


METHODS
We retrospectively analyzed factors associated with mortality in 580 patients with acute myocardial infarction presented to the Emergency Ward and Emergency Intensive Care Unit (EICU) of Beijing Anzhen Hospital from March 2004 to March 2006 (428 males, average age: 60.7 +/- 12.9 years). The patients were divided to 3 groups according various therapies: thrombolysis, PCI/CABG or symptomatic medication groups.


RESULTS
The median PDT was 130 min. Thrombolysis, PCI/CABG and medical therapy were applied in 122 (21.0%), 266 (45.9%) and 192 (33.1%) patients respectively. PDT was significantly longer in patients receiving medical therapy (290.9 min +/- 3.4 min) compared to patients treated with thrombolysis (104.5 min +/- 2.3 min) and PCI/CABG (119.1 min +/- 2.3 min, all P < 0.05). The overall mortality rate was 5.3% (31/580) and all occurred in patients with medical therapy group mostly due to irreversible ventricular fibrillations. Old age (OR = 1.047, P = 0.004), diabetes mellitus (OR = 2.159, P = 0.02) and PDT (OR = 2.159, P = 0.023) are independent predict factors for mortality.


CONCLUSIONS
Coronary Revascularisation by thrombolysis, PCI or CABG early post acute myocardial infarction is the key issue for reducing mortality in patients with acute myocardial infarction.
Guo
Lu-fen
LF
Emergency Center, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China. newsky_walker@sohu.com
Peng
Ya-guang
YG
Li
Qing-xiang
QX
He
Jian-hua
JH
Zhao
Dong
D
Hong
Zhao-guang
ZG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003951:Diagnostic Errors; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D010343:Patient Admission; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors