Delays in presentation with acute coronary syndrome in people with coronary artery disease in Australia and New Zealand

Mckinley, S; Aitken, LM; Marshall, AP; Buckley, T; Baker, H; Davidson, PM; Dracup, K

Delays in presentation with acute coronary syndrome in people with coronary artery disease in Australia and New Zealand

Mckinley, S Aitken, LM Marshall, AP Buckley, T Baker, H Davidson, PM

Dracup, K

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Publication Type:: Journal Article
Citation:: EMA - Emergency Medicine Australasia, 2011, 23 (2), pp. 153 - 161
Issue Date:: 2011-04-01

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Field	Value	Language
dc.contributor.author	Mckinley, S	en_US
dc.contributor.author	Aitken, LM	en_US
dc.contributor.author	Marshall, AP	en_US
dc.contributor.author	Buckley, T	en_US
dc.contributor.author	Baker, H	en_US
dc.contributor.author	Davidson, PM https://orcid.org/0000-0003-2050-1534	en_US
dc.contributor.author	Dracup, K	en_US
dc.date.issued	2011-04-01	en_US
dc.identifier.citation	EMA - Emergency Medicine Australasia, 2011, 23 (2), pp. 153 - 161	en_US
dc.identifier.issn	1742-6731	en_US
dc.identifier.uri	http://hdl.handle.net/10453/18527
dc.description.abstract	Objectives: To report time from the onset of symptoms to hospital presentation in Australian and New Zealand patients with subsequently confirmed acute coronary syndrome, and to identify factors associated with prehospital delay time in these patients. Methods: Patients with coronary artery disease enrolled in a randomized clinical trial testing an intervention to reduce delay in responding to acute coronary syndrome symptoms had been followed for 24months. In cases of admission to the ED for possible acute coronary syndrome, medical records were reviewed to determine the diagnosis, prehospital delay time, mode of transport to the hospital and aspirin use before admission. Clinical and demographic data were taken from the trial database. Results: Patients (n= 140) had an average (SD) age of 67.3 (11.5) years; 36% were female. Two-thirds of patients went to hospital by ambulance and 89.3% had a final diagnosis of unstable angina. The median time from onset of symptoms to arrival at the ED was 2h and 25min (interquartile range 1:25-4:59); 12.1% arrived ≤ 1h and 66% within 4h. Multiple linear regression analysis showed that use of ambulance (Beta = 0.247, P= 0.012) and younger age (Beta = 0.198, P= 0.043) were independent predictors of shorter delay times. Conclusion: The time from the onset of symptoms to hospital presentation was too long for maximal benefit from treatment in most patients. Further efforts are needed to reduce treatment-seeking delay in response to symptoms of acute coronary syndrome. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.	en_US
dc.relation.ispartof	EMA - Emergency Medicine Australasia	en_US
dc.relation.isbasedon	10.1111/j.1742-6723.2011.01385.x	en_US
dc.subject.classification	Emergency & Critical Care Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Angina, Unstable	en_US
dc.subject.mesh	Health Status Indicators	en_US
dc.subject.mesh	Multivariate Analysis	en_US
dc.subject.mesh	Linear Models	en_US
dc.subject.mesh	Risk Assessment	en_US
dc.subject.mesh	Time Factors	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Emergency Service, Hospital	en_US
dc.subject.mesh	Health Services Needs and Demand	en_US
dc.subject.mesh	Health Services Accessibility	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	New Zealand	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Coronary Artery Disease	en_US
dc.subject.mesh	Acute Coronary Syndrome	en_US
dc.title	Delays in presentation with acute coronary syndrome in people with coronary artery disease in Australia and New Zealand	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	23	en_US
utslib.for	1102 Cardiorespiratory Medicine and Haematology	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
dc.location.activity	WOS:000289523300006	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
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
utslib.copyright.status	closed_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	23	en_US

Abstract:

Objectives: To report time from the onset of symptoms to hospital presentation in Australian and New Zealand patients with subsequently confirmed acute coronary syndrome, and to identify factors associated with prehospital delay time in these patients. Methods: Patients with coronary artery disease enrolled in a randomized clinical trial testing an intervention to reduce delay in responding to acute coronary syndrome symptoms had been followed for 24months. In cases of admission to the ED for possible acute coronary syndrome, medical records were reviewed to determine the diagnosis, prehospital delay time, mode of transport to the hospital and aspirin use before admission. Clinical and demographic data were taken from the trial database. Results: Patients (n= 140) had an average (SD) age of 67.3 (11.5) years; 36% were female. Two-thirds of patients went to hospital by ambulance and 89.3% had a final diagnosis of unstable angina. The median time from onset of symptoms to arrival at the ED was 2h and 25min (interquartile range 1:25-4:59); 12.1% arrived ≤ 1h and 66% within 4h. Multiple linear regression analysis showed that use of ambulance (Beta = 0.247, P= 0.012) and younger age (Beta = 0.198, P= 0.043) were independent predictors of shorter delay times. Conclusion: The time from the onset of symptoms to hospital presentation was too long for maximal benefit from treatment in most patients. Further efforts are needed to reduce treatment-seeking delay in response to symptoms of acute coronary syndrome. © 2011 The Authors. EMA © 2011 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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http://hdl.handle.net/10453/18527