[Factors associated with delay in calling Emergency Medical Services ("15") for patients with ST-elevation myocardial infarction in southern Isère].
BACKGROUND
Time until revascularization is an important prognostic factor for patients with ST-elevation myocardial infarction. The objective of this study was to investigate the factors associated with patients' delay in calling for emergency medical services (SAMU, "15" in France).


METHODS
We analyzed the original data of a permanent prospective register of patients receiving care from mobile intensive care units staffed by emergency physicians and dispatched by SAMU in southern Isère (France), from October 1, 2002, through December 31, 2004.


RESULTS
Of the 380 patients analyzed, 71% were men and 15% had a history of coronary disease. The median age was 60 years for men and 72 for women. The median time from symptom onset to calling SAMU was 63 minutes (interquartile range, 27 to 144). In the univariate analyses, the time to the call was higher for women (90 v 58, p<0.01) and increased with age (p<0.01) and prior calls to a physician or nurse (115 v 45, p<0.001). In the multivariable analysis, factors independently associated with delay in calling SAMU included female gender, age of 55-64 years, prior calls to a physician or nurse, and onset of pain during the weekend or at night. The media call delay did not differ for patients with and without a history of coronary disease.


CONCLUSIONS
The subpopulations of patients characterized by the factors associated with delayed calls should be the target of programs to stress the importance of calling SAMU quickly, regardless of the time of day; the effectiveness of these programs should be evaluated by randomized studies before they enter general use.
Service d'aide médicale urgente (Samu 38), Centre hospitalier universitaire, F-38000 Grenoble, France.
Anne-Sophie
AS
Lucas
Guillaume
G
Debaty
Magali
M
Fourny
Loïc
L
Belle
Hervé
H
Labourel
Christophe
C
Escallier
Marie-Hélène
MH
Schmidt
Philippe
P
Terraube
Gérald
G
Vanzetto
Patrice
P
François
José
J
Labarère
D000368:Aged; D004562:Electrocardiography; D004631:Emergency Medical Service Communication Systems / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors