Key result
Self-transporting to the emergency department and presenting with unusual fatigue were associated with significantly longer prehospital delays for suspected ACS (TR 1.93, P<0.001 and TR 1.71, P=0.002).
Why the study?
Rapid reperfusion reduces infarct size and mortality in ACS in a time-dependent manner, motivating an evaluation of whether transportation factors and clinical presentation predict prehospital delay.
Do transportation factors and clinical presentation predict prehospital delay in patients with suspected acute coronary syndrome?
Population
609 men and 366 women with symptoms suggestive of ACS at 5 US sites
Comparison
Predictors of prehospital delay stratified by final diagnosis of ACS vs no ACS
Design
Multicenter observational study
Authors
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Highlights need for atypical symptom education and EMS activation; hypothesis-generating for targeted delay-reduction interventions.
Observational (n=975)
Yes
Do transportation factors and clinical presentation predict prehospital delay in patients with suspected acute coronary syndrome?
Effect estimate: TR 1.93
p-value: p=<0.001
Self-transportation to the ED and presentation with unusual fatigue are associated with significantly prolonged prehospital delays in patients with suspected ACS, highlighting the need to encourage EMS utilization.
DeVon et al. (2020) conducted an observational in Suspected acute coronary syndrome (n=975). Self-transporting to the ED and unusual fatigue vs. EMS transport and absence of unusual fatigue was evaluated on Prehospital delay time (TR 1.93, p=<0.001). Self-transporting to the emergency department and presenting with unusual fatigue were associated with significantly longer prehospital delays for suspected ACS (TR 1.93, P<0.001 and TR 1.71, P=0.002).
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