Impact of Prodromal Symptoms on Prehospital Delay in Patients With First-Time Acute Myocardial Infarction in Korea
Impact of Prodromal Symptoms on Prehospital Delay in Patients With First-Time Acute Myocardial Infarction in Korea
复制标题
DOI：
10.1097/jcn.0b013e3181f3e2e0
复制
发表时间：
2011-05-01
影响因子：
2
通讯作者：
Jeong, Myung Ho
中科院分区：
文献类型：
--
作者：
Hwang, Seon Young;Zerwic, Julie J.;Jeong, Myung Ho
背景资料：关于受影响的个体在急性冠状动脉事件之前如何对早期预警信号作出反应以及前驱症状的存在如何影响院前延迟的信息有限。目的：本研究的目的是确定首次急性心肌梗死（AMI）患者前驱症状的特征和解释，并确定前驱症状的存在是否预示着院前延迟。研究对象与方法：本研究为描述性研究，采用半结构式访谈法。从2007年11月到2008年12月，在韩国的一所大学医院，共有271名被诊断为AMI的住院患者接受了采访。询问患者在急性心脏事件发生前是否注意到最令人不安的前驱症状以及他们对症状的反应。结果：男性（53.0%）和女性（54.2%）有前驱症状。报告前驱症状的患者比无前驱症状的患者更可能年龄更大，住院时无胸痛。许多患者通常没有认识到他们的警告症状的重要性;只有约40%的患者在出现任何前驱症状时去诊所就诊。Logistic回归分析显示，前驱症状的存在是影响院前延迟超过3小时和超过12小时的独立预测因素。结论：认识到前驱症状需要注意可能是患者早期寻求医疗帮助的触发因素。教育策略应侧重于提高对AMI前驱症状的认识，特别是那些有家族史或心血管疾病高危人群。
Background: Information is limited concerning how affected individuals respond to early warning signs before their acute coronary event and how the presence of prodromal symptoms impacts prehospital delay. Objectives: This study's aim was to identify the characteristics and interpretation of prodromal symptoms in patients with a first-time acute myocardial infarction (AMI) and to determine whether the presence of prodromal symptoms was predictive of prehospital delay. Subjects and Methods: This was a descriptive study using semistructured interview. A total of 271 hospitalized patients diagnosed as having AMI were interviewed from November 2007 to December 2008 at a university hospital in Korea. Patients were queried regarding whether they noticed a most troubling prodromal symptom prior to their acute cardiac event and how they responded to the symptom. Results: Men (53.0%) and women (54.2%) experienced prodromal symptoms. Patients who reported prodromal symptoms were more likely to be older and to have no chest pain upon hospitalization than those with no prodromes. Many patients did not generally recognize the importance of their warning symptoms; only about 40% visited a clinic in response to any prodromal symptom. Logistic regression analyses revealed that the presence of prodromal symptoms was an independent predictor affecting prehospital delay of more than 3 hours and more than 12 hours. Conclusions: Recognizing prodromal symptoms as needing attention could be a trigger for patients to seek medical help earlier. Educational strategies should focus on improving awareness of prodromal symptoms of AMI, particularly in those with a family history or at high risk for cardiovascular disease.