title: Prehospital delay in patients presenting with acute ST-elevation myocardial infarction.
abstract: To characterize prehospital delays in patients presenting with acute ST-elevation myocardial infarction to the emergency department of a tertiary hospital in Asia. A retrospective review of 273 patients with diagnosis of ST-elevation myocardial infarction; symptom to door (S2D) time was described in two ways, time from first onset of symptoms; and time from the onset of the worst episode to presentation at emergency department. The median first onset S2D time was 173 min (interquartile range 80-350 min); and median worst episode S2D time was 131 min (interquartile range 70-261 min). Patients with prehospital delay tended to use their own transport compared with the no delay group (P=0.026, 95% confidence interval=0.02-0.24). There was no difference in S2D times for typical compared with atypical symptoms. A large proportion of patients experienced delay in seeking medical care after the onset of acute coronary symptoms. Self-transport was associated with delay.
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore General Hospital, Singapore. choonchiet@gmail.com
authors.forename: Choon Chiet
authors.initials: CC
authors.lastname: Hong
authors.forename: Papia
authors.initials: P
authors.lastname: Sultana
authors.forename: Aaron Sung Lung
authors.initials: AS
authors.lastname: Wong
authors.forename: Kim Poh
authors.initials: KP
authors.lastname: Chan
authors.forename: Pin Pin
authors.initials: PP
authors.lastname: Pek
authors.forename: Marcus Eng Hock
authors.initials: ME
authors.lastname: Ong
mesh_terms: D016001:Confidence Intervals; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012846:Singapore; D013997:Time Factors; D014187:Transportation of Patients