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Korean J Med > Volume 87(4); 2014 > Article
The Korean Journal of Medicine 2014;87(4): 429-438.
ST분절 상승 심근경색증 환자에서 증상 발생 후 응급센터 도착 시간 지연에 영향을 주는 요인
이재훈1,2, 정명호1,2, 이정애3, 최진수3, 박인혜4, 채임순5, 장수영1,2, 조재영1,2, 정해창1,2, 이기홍1,2, 박근호1,2, 심두선1,2, 김계훈1,2, 홍영준1,2, 박형욱1,2, 김주한1,2, 안영근1,2, 조정관1,2, 박종춘1,2
1전남대학교병원 심장센터
2보건복지부 지정 심장질환 특성화 연구센터
3전남대학교 의과대학 예방의학교실
4전남대학교 간호대학
5광주기독 간호대학
Factors Influencing Delay in Symptom-to-Door Time in Patients with Acute ST-Segment Elevation Myocardial Infarction
Jae Hoon Lee1,2, Myung Ho Jeong1,2, Jung Ae Rhee3, Jin Su Choi3, In Hyae Park4, Leem Soon Chai5, Soo Yong Jang1,2, Jae Young Cho1,2, Hae Chang Jeong1,2, Ki Hong Lee1,2, Keun-Ho Park1,2, Doo Sun Sim1,2, Kye Hun Kim1,2, Young Joon Hong1,2, Hyung Wook Park1,2, Ju Han Kim1,2, Young keun Ahn1,2, Jeong Gwan Cho1,2, Jong Chun Park1,2
1The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
2The Heart Research Center Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
3Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
4Nursing Department of Chonnam National University, Gwangju, Korea
5Gwangju Christian College of Nursing, Gwangju, Korea
Corresponding Author: Myung Ho Jeong ,Tel: +82-62-220-6243, Fax: +82-62-228-7174, Email: myungho@chollian.net, mhjeong@chonnam.ac.kr
Received: October 7, 2013;   Revised: December 27, 2013;   Accepted: May 3, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/bync/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background/Aims:
Delay in symptom-to-door time (SDT) in patients with acute ST-segment elevation myocardial infarction (STEMI) is the most important factor in the prediction of short and long-term mortality. The purpose of this study was to investigate the social and clinical factors affecting SDT in patients with STEMI.
Methods:
We analyzed 784 patients (61.0 ± 13.2 years, 603 male) diagnosed with STEMI from November 2005 to February 2012. The patients were divided into four groups according to SDT: Group I (n = 163, ≤ 1 h), Group II (n = 183, 1-2 h), Group III (n = 142, 2-3 h) and Group IV (n = 296, > 3 h).
Results:
Delay in SDT increased with age (Group I, 58.4 ± 12.0; Group II, 59.4 ± 13.3; Group III, 62.0 ± 12.8; Group IV, 63.0 ± 13.8 years, p = 0.001). In 119 patients, transportation was less frequently used as the delay in SDT (41.7% vs. 29.0% vs. 26.1% vs. 9.8%, p < 0.001). By multiple logistic regression analysis, family history [OR, 0.488; CI, 0.248-0.959; p = 0.037], previous ischemic heart disease [OR, 0.572; CI, 0.331-0.989; p = 0.045], no occupation [OR, 1.600; CI, 1.076-2.380; p = 0.020] and method of transportation [OR, 0.353; CI, 0.239-0.520; p < 0.001] were independent predictors of delay in SDT.
Conclusions:
Our study shows that general education about cardiovascular symptoms and a prompt emergency call could be important to reduce SDT in STEMI.
Keywords: Myocardial infarction; Symptom to balloon time; Mortality
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