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    Prehospital transport of patients with acute myocardial infarction: a community-wide perspective

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    Authors
    Goldberg, Robert J.
    Kramer, Daniel G.
    Yarzebski, Jorge L.
    Lessard, Darleen M.
    Gore, Joel M.
    UMass Chan Affiliations
    Department of Medicine, Division of Cardiovascular Medicine
    Document Type
    Journal Article
    Publication Date
    2008-07-16
    Keywords
    Aged
    Ambulances
    Data Collection
    Emergency Medical Services
    Female
    Humans
    Logistic Models
    Male
    Massachusetts
    Medical Records
    Middle Aged
    Myocardial Infarction
    Transportation of Patients
    Life Sciences
    Medicine and Health Sciences
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    Link to Full Text
    http://dx.doi.org/10.1016/j.hrtlng.2007.05.013
    Abstract
    OBJECTIVE: The objectives of this population-based study were to examine the use of emergency medical services (EMS) in greater Worcester, Massachusetts, residents (2000 census = 478,000) hospitalized with acute myocardial infarction (AMI) at all metropolitan Worcester medical centers in four biennial periods between 1997 and 2003. A secondary study aim was to describe the demographic and clinical characteristics of patients with AMI transported to metropolitan Worcester hospitals by EMS, compared with those transported by other means, and their hospital outcomes. METHODS: We reviewed the medical records of 3805 patients hospitalized for confirmed AMI at 11 greater Worcester medical centers during 1997, 1999, 2001, and 2003. Information about the use of EMS, patient characteristics, and hospital outcomes was obtained through the review of hospital charts. RESULTS: A total of 2693 greater Worcester residents with AMI (70.8%) were transported to area hospitals by ambulance. Patients transported by ambulance were older, were more likely to be women, had a greater prevalence of comorbidities, and had a different symptom profile than patients transported by other means. Patients arriving at greater Worcester hospitals by ambulance were more likely to develop serious clinical complications, including heart failure and cardiogenic shock, and die during hospitalization compared with patients not transported by EMS. CONCLUSIONS: Our results suggest that the majority of greater Worcester residents seeking care for AMI are transported by EMS. Patients transported by ambulance differ from patients transported by other means and are more likely to experience adverse hospital outcomes. The reasons why patients use EMS in the setting of AMI need to be further explored and patients' care-seeking behavior enhanced.
    Source
    Heart Lung. 2008 Jul-Aug;37(4):266-74. Link to article on publisher's site
    DOI
    10.1016/j.hrtlng.2007.05.013
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49431
    PubMed ID
    18620102
    Notes
    Medical student Daniel Kramer participated in this study as part of the Senior Scholars research program.
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.hrtlng.2007.05.013
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    T.H. Chan School of Medicine Student Publications
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