Causes of Late Referral to the Emergency Department in Patients with Myocardial Infarction in Iran - - - Razlozi kasnijeg upućivanja bolesnika sa infarktom miokarda u urgentni centar u Iranu
Journal Title: Acta Facultatis Medicae Naissensis - Year 2018, Vol 35, Issue 2
Abstract
Late referral of patients with myocardial infarction is one of the main causes of morbidity or mortality in these patients. Therefore, this study aimed to investigate the factors involved in the late referral of patients with heart attacks to the emergency department. A descriptive cross-sectional study was conducted on 148 patients with myocardial infarction referred to the emergency department. They were chosen using a census method. A researcher-made questionnaire was developed and assessed in terms of validity and reliability for data collection. Inclusion criteria included suffering from chest pain or other symptoms indicative of acute myocardial infarction, age above 18 years, tendency to take part in this study, patients with acute myocardial infarction who had late referral and were admitted to cardiac care unit for at least 48 hours. Data was analyzed using descriptive and inferential statistics via SPSS software. P < 0.05 denoted statistical significance. Pain improvement with rest (85.8%), severity of chest pain and lack of familiarity with the symptoms of heart diseases and abnormal cardiac symptoms (87.8%), confusion of heart problems with musculoskeletal problems (70.2%), and the presence of concomitant diabetes were important factors influencing late referral to the emergency department. The average time to reach the emergency department after the onset of the heart problem was 24 ± 3 hours. A lack of patients’ familiarity with cardiovascular symptoms and acute myocardial infarction calls the need to educate the society about symptoms and the need for an early referral to healthcare settings. - - - Kasnije upućivanje pacijenata sa infarktom miokarda jedan je od glavnih uzroka morbiditeta i mortaliteta kod ovih bolesnika. Cilj ove studije bio je utvrđivanje faktora koji utiču na kasno upućivanje bolesnika sa srčanim udarom lekaru Urgentnog centra. Ova deskriptivna studija preseka uključila je 148 bolesnika sa infarktom miokarda koji su upućeni u urgentni centar. Učesnici studije birani su primenom metode cenzusa. Upitnik koji su sačinili istraživači osmišljen je i analiziran u smislu validnosti i pouzdanosti prikupljenih podataka. Kriterijumi za učestvovanje u studiji su uključili: prisustvo bola u grudima ili pojavu drugih simptoma koji su ukazivali na akutni infarkt miokarda, starost bolesnika iznad 18 godina, spremnost za učestvovanje u studiji, i na kraju bolesnike sa akutnim infarktom miokarda koji su bili kasno upućeni i primljeni u koronarnu jedinicu u okviru od najmanje 48 sati. Podaci su analizirani korišćenjem deskriptivne i inferencijalne statistike primenom SPSS softvera. Vrednost P < 0.05 uzeta je kao statistička značajnost. Kao važni faktori koji su uticali na kasno upućivanje pacijenata lekaru urgentnog centra navedeni su: smanjenje bola nakon odmora (85,8%), jak bol u grudima i nepoznavanje simptoma srčane bolesti i abnormalnih srčanih simptoma (87,8%), zamena srčanih tegoba sa muskuloskeletalnim problemima (70,2%), kao i prisustvo dijabetesa melitusa. Prosečno vreme dolaska u urgentni centar od pojave srčanih tegoba bilo je 24 ± 3 sata. Nepoznavanje kardiovaskularnih simptoma, kao i simptoma akutnog infarkta miokarda, upućuje na neophodnost edukacije društva o ovim simptomima i rano upućivanje u zdravstvene centre.
Authors and Affiliations
Mojtaba Rad, Akram Bidi, Gholam Reza Khaligh, Mostafa Rad
Keywords
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- EP ID EP349337
- DOI 10.2478/afmnai-2018-0012
- Views 89
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