Delays in presentation with acute coronary syndrome

January 01, 0001

Delays in presentation with acute coronary syndrome

The aim of this study was to report time from the onset of symptoms to hospital presentation in Australian and New Zealand patients with subsequently confirmed acute coronary syndrome, and to identify factors associated with prehospital delay time in these patients. Patients with coronary artery disease enrolled in a randomized clinical trial testing an intervention to reduce delay in responding to acute coronary syndrome symptoms had been followed for 24 months. In cases of admission to the ED for possible acute coronary syndrome, medical records were reviewed to determine the diagnosis, prehospital delay time, mode of transport to the hospital and aspirin use before admission. Clinical and demographic data were taken from the trial database. Patients (n= 140) had an average age of 67.3 years; 36% were female. Two-thirds of patients went to hospital by ambulance and 89.3% had a final diagnosis of unstable angina.

The median time from onset of symptoms to arrival at the ED was 2 h and 25 min. 12.1% arrived less than or equal to 1 h and 66% within 4 h. Multiple linear regression analysis showed that use of ambulance and younger age were independent predictors of shorter delay times.

The researchers concluded: "The time from the onset of symptoms to hospital presentation was too long for maximal benefit from treatment in most patients. Further efforts are needed to reduce treatment-seeking delay in response to symptoms of acute coronary syndrome."

Timing can certainly be improved in this area.

For the full abstract, click here.

Emergency Medicine Australasia online 10 February 2011
© 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Delays in presentation with acute coronary syndrome in people with coronary artery disease in Australia and New Zealand. Sharon McKinley, Leanne M Aitken, Andrea P Marshall et al.

Category: K. Circulatory, HSR. Health Services Research. Keywords: acute coronary syndrome, coronary artery disease, emergency medical service, prehospital delay, randomized clinical trial, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 4 March 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.