Impact of prehospital delay in treatment seeking on in-hospital complications after acute myocardial infarction

Wu, JR; Moser, DK; Riegel, B; McKinley, S; Doering, LV

Impact of prehospital delay in treatment seeking on in-hospital complications after acute myocardial infarction

Wu, JR Moser, DK Riegel, B McKinley, S Doering, LV

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Publication Type:: Journal Article
Citation:: Journal of Cardiovascular Nursing, 2011, 26 (3), pp. 184 - 193
Issue Date:: 2011-05-01

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Field	Value	Language
dc.contributor.author	Wu, JR	en_US
dc.contributor.author	Moser, DK	en_US
dc.contributor.author	Riegel, B	en_US
dc.contributor.author	McKinley, S	en_US
dc.contributor.author	Doering, LV	en_US
dc.date.issued	2011-05-01	en_US
dc.identifier.citation	Journal of Cardiovascular Nursing, 2011, 26 (3), pp. 184 - 193	en_US
dc.identifier.issn	0889-4655	en_US
dc.identifier.uri	http://hdl.handle.net/10453/16940
dc.description.abstract	Background: Rapid arrival to the hospital for treatment of acute myocardial infarction (AMI) improves long-term outcomes. Whether prehospital delay time is associated with short-term, in-hospital complications remains unknown. Objective: The purpose of this study was to evaluate the fit of a theoretical model where prehospital delay time was indirectly associated with hospital length of stay through in-hospital complications after AMI considering simultaneously for demographic, clinical, and psychosocial factors using structural equation modeling. Methods: Acute myocardial infarction patients (N = 536; 66% men; mean age, 62 [SD, 14] years) were enrolled in this prospective study. Demographic and clinical data were obtained by patient interview and medical record review. After patient discharge, complications were abstracted from the medical record. Results: Prehospital delay, admission Killip class, and in-hospital anxiety were the best predictors of in-hospital complications, including recurrent ischemia, reinfarction, sustained ventricular tachycardia or fibrillation, and cardiac death, after AMI (P = .019). The occurrence of in-hospital complications was related to length of stay in the hospital (P < .001). Conclusion: Prehospital delay in promptly seeking hospital treatment for AMI symptoms, together with state anxiety and worse heart failure, was associated with the occurrence of more frequent serious complications during the hospital stay. It is essential that research and clinical efforts focus on the complex and dynamic issue of improving prehospital delay in AMI patients. Copyright © 2011 Lippincott Williams & Wilkins.	en_US
dc.relation.ispartof	Journal of Cardiovascular Nursing	en_US
dc.relation.isbasedon	10.1097/JCN.0b013e3181efea66	en_US
dc.subject.classification	Nursing	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Myocardial Infarction	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Length of Stay	en_US
dc.subject.mesh	Regression Analysis	en_US
dc.subject.mesh	Prospective Studies	en_US
dc.subject.mesh	Anxiety	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Emergency Medical Services	en_US
dc.subject.mesh	Patient Acceptance of Health Care	en_US
dc.subject.mesh	United States	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Impact of prehospital delay in treatment seeking on in-hospital complications after acute myocardial infarction	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	26	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
utslib.for	1110 Nursing	en_US
dc.location.activity	WOS:000289404100004	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	26	en_US

Abstract:

Background: Rapid arrival to the hospital for treatment of acute myocardial infarction (AMI) improves long-term outcomes. Whether prehospital delay time is associated with short-term, in-hospital complications remains unknown. Objective: The purpose of this study was to evaluate the fit of a theoretical model where prehospital delay time was indirectly associated with hospital length of stay through in-hospital complications after AMI considering simultaneously for demographic, clinical, and psychosocial factors using structural equation modeling. Methods: Acute myocardial infarction patients (N = 536; 66% men; mean age, 62 [SD, 14] years) were enrolled in this prospective study. Demographic and clinical data were obtained by patient interview and medical record review. After patient discharge, complications were abstracted from the medical record. Results: Prehospital delay, admission Killip class, and in-hospital anxiety were the best predictors of in-hospital complications, including recurrent ischemia, reinfarction, sustained ventricular tachycardia or fibrillation, and cardiac death, after AMI (P = .019). The occurrence of in-hospital complications was related to length of stay in the hospital (P < .001). Conclusion: Prehospital delay in promptly seeking hospital treatment for AMI symptoms, together with state anxiety and worse heart failure, was associated with the occurrence of more frequent serious complications during the hospital stay. It is essential that research and clinical efforts focus on the complex and dynamic issue of improving prehospital delay in AMI patients. Copyright © 2011 Lippincott Williams & Wilkins.

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http://hdl.handle.net/10453/16940