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Influence of health-related quality of life in myocardial infarction with regard to the time from symptom onset to hospital arrival, and the risk of re-admission
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research Center.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Despite increased awareness of the importance of early treatment in acutemyocardial infarction (AMI), the delay from symptom onset until hospital arrival is still too longand re-hospitalisations are frequent. Little is known about how health-related quality of life(HRQL) affects delay time and the frequency of re-admissions.Method: We used quality registers to investigate whether patients’ HRQL has any impact ondelay time with a new AMI, and on the rate of re-admissions during the first year. AMI-patients<75 years, with HRQL assessed with EQ-5D at one-year follow-up, and who thereafter had anew AMI registered, were evaluated for the correlation between HRQL and delay time (n=454).The association between HRQL and re-admissions was evaluated among those who had anadditional one-year follow-up registration after the new AMI (n=216).Results: Patients who reported poor total health status (EQ-VAS ≤50), compared to those whoreported EQ-VAS 81-100, had tripled risk to delay ≥2 hours from symptom onset to hospitalarrival (adjusted OR 3.01, 95% CI: 1.43-6.34). Patients scoring EQ-VAS ≤50 had a higher riskof re-admissions in the univariate analysis (OR 3.08, 95% CI: 1.71-5.53). However, thecorrelation did not remain significant after adjustment (OR 1.99, 95% CI: 0.90-4.38). EQ-indexwas not independently associated with delay time or re-admissions.Conclusion: Aspects of total health status post-AMI were independently associated with delaytime to hospital arrival in case of a new AMI. However, the influence of total health status on therisk of re-admissions was less clear.

Keyword [en]
AMI, quality of life, delay time, re-admission, depression, anxiety
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-156575OAI: oai:DiVA.org:uu-156575DiVA: diva2:432557
Available from: 2011-08-04 Created: 2011-08-04 Last updated: 2011-08-26Bibliographically approved
In thesis
1. Coronary Heart Disease and Early Decision Making, from Symptoms to Seeking Care: Studies with Focus on Pre-hospital Delay in Acute Myocardial Infarction Patients
Open this publication in new window or tab >>Coronary Heart Disease and Early Decision Making, from Symptoms to Seeking Care: Studies with Focus on Pre-hospital Delay in Acute Myocardial Infarction Patients
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Despite several investigations and interventions aimed at decreasing the time from symptom onset to medical care seeking in acute myocardial infarction patients, the delay time is still too long for best treatment outcomes. In this thesis, investigations aimed at improving our understanding of the factors influencing delay time are evaluated, as well as attitudes to medical care seeking in patients, relatives and the general public. Additionally, an evaluation was performed to examine whether health-related quality of life had any influence on delay time and re-admissions.

Participating patients, relatives and representatives of the general public were generally knowledgeable about acute myocardial infarction (AMI) and its symptomatology. The majority of participants knew about the importance of receiving fast treatment when an AMI occurs. Despite people’s knowledge, several patients and relatives felt uncertain of symptom origin and how to act at symptom onset. Patients commonly consulted an additional person when symptoms did not disappear. However, people appeared to act more appropriately if someone else had chest pain compared to self-experienced symptoms.

In patients who had suffered from more than one AMI, poor total health status increased the risk of delaying for more than two hours, but no independent association was found between total health status and re-admissions within the first year post-AMI.

Place, publisher, year, edition, pages
Uppsala: Acta Universitetis Upsaliensis, 2011. 71 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 685
Acute Myocardial Infarction, Pre-Hospital Delay, Knowledge, Attitudes, Decision Making, Quality of Life, Re-admission
National Category
Medical and Health Sciences
urn:nbn:se:uu:diva-156636 (URN)978-91-554-8114-8 (ISBN)
Public defence
2011-09-16, Enghoffsalen, Akademiska sjukhuset, Uppsala, 13:00 (Swedish)
Available from: 2011-08-25 Created: 2011-08-04 Last updated: 2011-09-08

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Henriksson, Catrin
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