Factors Associated with Delay First Medical Contact to Device Time in Patient with Acute ST-Segment Elevation Myocardial Infarction at Emergency Department, Nopparat Rajathanee Hospital

Authors

  • Chalermpon Chairat M.D.

Keywords:

First medical contact to device time, ST-segment elevation myocardial infarction, Emergency severity index

Abstract

Background : Patients with acute ST-segment elevation myocardial infarction (STEMI) should properly treat as soon as possible to decrease mortality. In 2017 for non-percutaneous coronary intervention capable hospital, the American Heart Association recommends the first medical contact (FMC) to device time should not exceed 120 minutes to achieve a better survival.

Objective : To determine the factors associated with delayed first medical contact to device time >120 minutes in STEMI patients at the emergency department, Nopparat Rajathanee Hospital.

Methods : A cross-sectional study was conducted in patients who were diagnosed with acute STEMI at the emergency department from January 2014 to September 2017. The patients were divided into two groups, first medical contact to device time ≤120 minutes and >120 minutes. The collected data includes age, sex, underlying diseases, presenting symptoms, emergency severity index (ESI), and complications. The factors associated with delay first medical contact to device time were analyzed by univariate and multivariate logistic regression.

Results : 217 patients were enrolled. Male 173 patients (79.72%), female 44 patients (20.28%). The median time of FMC to device time was 178 minutes. The factors associated with delayed first medical contact to device time were ESI level 3 (OR 95% CI = 24.99 (3.2-202), p-value 0.003), and ESI level 4 (OR 95% CI = 12.29 (1.44-104), p-value 0.021).

Conclusion : A miss evaluation from chief complaint symptom to ESI triage level 3 and 4 associated with delayed first medical contact to device time more than 120 minutes. An effective triage system and the further capable of percutaneous coronary intervention in the Nopparat Rajathanee Hospital will decrease the first medical contact to device time.

References

Srimahachota S, Kanjanavanit R, Boonyaratavej S,BoonsomW, Veerakul G, Tresukosol D. Demographic,management practices and in-hospital outcomes of Thai Acute Coronary Syndrome Registry(TACSR): the difference from the Western world. J Med Assoc Thai 2007; 90:1-11.

Chan MY, Du X, Eccleston D, Ma C, Mohanan PP, Ogita M, et al. Acute coronary syndrome in the Asia-Pacific region. Int J Cardiol 2016; 202:861–9.

Jneid H, Addison D, Bhatt DL, Fonarow GC, Gokak S, Grady KL, et al. 2017 AHA/ACC Clinical Performance and Quality Measures for Adults With ST-Elevation and Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Circ Cardiovasc Qual Outcomes.2017; 10:e000032.

Carrillo X, Fernandez-Nofrerias E, Rodriguez-Leor O, Oliveras T,Serra J, Mauri J, et al. Early ST elevation myocardial infarction in non-capable percutaneous coronary intervention centres:in situ fibrinolysis vs.percutaneous coronary intervention transfer. Eur Heart J 2016; 37: 1034–40.

Park YH, Kang GH, Song BG, Chun WJ, Lee JH, Hwang SY, et al.Factor related to prehospital time delay in acute ST-segment elevation myocardial infarction. J Korean Med Sci 2012; 27:864-9.

Clare L Atzema, Peter C Austin, Jack V Tu, Michael J Schull.Emergency department triage of acute myocardial infarction patients and the effect on outcomes. Ann Emerg Med 2008;53:736-45.

Michael D Miedema, Marc C Newell, Sue Duval, Ross F Garberich, Chauncy B Handran, David M Larson, et al.Causes of delay and associated mortality in patients transferred with ST-segment–elevation myocardial infarction. Circulation 2011; 124:1636-44.

Tra J, van der Wulp I, de Bruijne MC, Wagner C. Exploring the treatment delay in the care of patients with STelevation myocardial infarction undergoing acute percutaneous coronary intervention: a cross-sectional study.BMC Health Serv Res 2015; 15:340.

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Published

10-03-2021

How to Cite

1.
Chairat C. Factors Associated with Delay First Medical Contact to Device Time in Patient with Acute ST-Segment Elevation Myocardial Infarction at Emergency Department, Nopparat Rajathanee Hospital. J DMS [Internet]. 2021 Mar. 10 [cited 2024 Mar. 29];45(4):122-8. Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/249789

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Original Article