Comparison of delay times to hospital presentation for physicians and nonphysicians with acute myocardial infarction.
Comparison of delay times to hospital presentation for physicians and nonphysicians with acute myocardial infarction.
复制标题
急性心肌梗死医生和非医生到医院就诊的延迟时间的比较。
DOI：
10.1016/0002-9149(92)91381-d
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Buring,JE
中科院分区：
文献类型：
--
作者：
Ridker,PM;Manson,JE;Goldhaber,SZ;Hennekens,CH;Buring,JE
为了评估识别心肌缺血症状并易于获得医疗护理的患者是否缩短了症状发作和住院之间的时间延迟，在医生健康研究（PHS）中，258名经历首次急性心肌梗死（AMI）的美国男性医生的症状发作和到达医院之间的总时间间隔与在美国第二次国际梗死生存研究（ISIS-2）中登记的240名男性患者的症状发作和到达医院的时间间隔进行了比较，并与先前发表的AMI患者系列进行了比较。对于症状出现24小时内就诊的患者，PHS组从症状出现到就诊的中位延迟时间为1.8小时，而ISIS-2组的美国组为4.9小时（p < 0.001）。此外，56%的PHS参与者在症状出现2小时内就诊，72%在症状出现4小时内就诊，而ISIS-2参与者的这一比例分别为20% （p < 0.001）和44% （p < 0.001）。在以前发表的系列报告中，到提交报告的平均时间与ISIS-2试验相当，但根据原产国和当地人口密度而有所不同。到就诊的中位时间在以往任何系列中都不比PHS短。因此，PHS的医生在症状发作和就诊之间的时间延迟显著缩短。这一差异可能有助于解释PHS项目中医生参与者的心血管死亡率远低于预期。此外，数据提供了令人鼓舞的证据，即可以实现从症状发作到医院就诊的较短延迟时间。
To evaluate whether patients who recognize the symptoms of myocardial ischemia and have easy access to medical care have shortened time delays between onset of symptoms and hospital presentation, the total time interval between symptom onset and hospital arrival for 258 U.S. male physicians experiencing a first acute myocardial infarction (AMI) in the Physicians' Health Study (PHS) was compared with that of a comparable group of 240 men enrolled in the U.S. component of the Second International Study of Infarct Survival (ISIS-2), as well as with those of previously published series of patients with AMI. For patients presenting for medical care within 24 hours of symptom onset, the median time delay from onset of symptoms to presentation for medical care was 1.8 hours in the PHS, and 4.9 hours in the U.S. component of ISIS-2 (p < 0.001). Furthermore, 56% of participants in the PHS presented for medical care within 2 hours and 72% within 4 hours of symptom onset compared with 20% (p < 0.001) and 44% (p < 0.001), respectively, for ISIS-2 participants. In previously published series, the average time to presentation was comparable to that in the ISIS-2 trial, with variation depending on country of origin and on local population density. The median time to medical presentation in any previous series was not shorter than that in the PHS. Thus, physicians in the PHS had significantly shorter time delays between onset of symptoms and presentation for medical care. This difference may help explain the far lower than expected cardiovascular mortality rates among physician participants in the PHS. Furthermore, the data provide encouraging evidence that shorter delay times from onset of symptoms to hospital presentation can be achieved.