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Fördröjningstider vid akut hjärtinfarkt
Uppsala University, Interfaculty Units, Centrum för klinisk forskning, Gävleborg.
Uppsala University, Interfaculty Units, Centrum för klinisk forskning, Gävleborg.
2004 (Swedish)Report (Other (popular scientific, debate etc.))
Abstract [en]

Research points to the importance of early treatment of acute heart infarction in order to

decrease the mortality and to improve the prognosis. In 1997 two hospitals from two closely

situated cities were consolidated into a common hospital, situated in the largest city. The aim

of this study was to investigate if the fusion of the hospitals influenced the delay times for the

patients in the catchments area, and to describe any differences between city and countryside.

Three data collections were made, one before the fusion, the second one year after and the last

one four years after the fusion. Each data collection included approximately 100 patients with

acute heart infarction who responded to a questionnaire. Data was also collected from the

journals of the respective patients. The second goal was to study if the delay time decreased,

when thrombolytic therapy was initiated pre-hospital compared to in-hospital. This was made

with a retrospective journal review.

The total delay time increased by 15 minutes between 1997 to 2001. In the smaller city, the

delay time increased by 30 minutes and in the surrounding countryside of the larger city the

increase was 52 minutes. The largest change in the patients contact pattern occurred in the

area where the hospital was closed. More people (38%) with chest pain visited the general

practitioner first, than before the fusion (17%) (p=0,042). This increased the time lapse before

they reached the hospital. In the same area transportation by ambulance to the hospital

increased from 68% to 94% (p=0,001), compared with unchanged 60% in that area where no

change of the hospital had occurred. The delay time increased with ascending age of the

patient and this trend was even more pronounced in 2001 compared with 1997 (p=0,040). The

hospital delay time increased in the emergency department from 30 minutes in 1997 to 40

minutes in 2001. The nearness to the hospital has an impact on the delay time, but no

significant differences could be shown, except between the larger city and its surrounding

countryside in 2001, where the difference was 155 minutes (p=0,003). Thrombolytic therapy

initiated pre-hospital decreased the delay by 45 minutes compared with therapy initiated

in-hospital, which showed a significant divergence (p=0,004).

Key words: acute myocardial infarction, pre-hospital delay, thrombolytic therapy

Place, publisher, year, edition, pages
URN: urn:nbn:se:uu:diva-71731OAI: oai:DiVA.org:uu-71731DiVA: diva2:99642
Available from: 2005-05-12 Created: 2005-05-12

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Rahm, Vivi-Anne
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Centrum för klinisk forskning, Gävleborg

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