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Gender disparities in first medical contact and delay in ST-elevation myocardial infarction: a prospective multicentre Swedish survey study
Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Department of Medicine, Stanford Prevention Research Center, CA, United States.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Department of Research, Norrbotten County Council, Luleå, Sweden.
Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
Department of Nursing, Umeå University, Umeå, Sweden; Cardiology, Heart Centre, Umeå University, Umeå, Sweden.
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2018 (engelsk)Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, nr 5, artikkel-id e020211Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objectives Compare gender disparities in ST-elevation myocardial infarction (STEMI) regarding first medical contact (FMC) and prehospital delay times and explore factors associated with prehospital delay in men and women separately. Design Cross-sectional study based on medical records and a validated questionnaire. Eligible patients were enrolled within 24 hours after admittance to hospital. Setting Patients were included from November 2012 to January 2014 from five Swedish hospitals with catheterisation facilities 24/7. Participants 340 men and 109 women aged between 31 and 95 years completed the survey. Main outcome measures FMC were divided into five possible contacts: primary healthcare centre by phone or directly, national advisory nurse by phone, emergency medical services (EMS) and emergency room directly. Two parts of prehospital delay times were studied: time from symptom onset to FMC and time from symptom onset to diagnostic ECG. Results Women more often called an advisory nurse as FMC (28% vs 18%, p=0.02). They had a longer delay until FMC, 90 (IOR 39-221) vs 66 (28-161) min, p=0.04 and until ECG, 146 (68-316) vs 103 (61-221) min, p=0.03. Men went to hospital because of believing they were stricken by an MI to a higher extent than women did (25% vs 15%, p=0.04) and were more often recommended to call EMS by bystanders (38% vs 22%, pamp;lt;0.01). Hesitating about going to hospital and experiencing pain in the stomach/back/shoulders were factors associated with longer delays in women. Believing the symptoms would disappear or interpreting them as nothing serious were corresponding factors in men. In both genders bystanders acting by contacting EMS explained shorter prehospital delays. Conclusions In STEMI, women differed from men in FMC and they had longer delays. This was partly due to atypical symptoms and a longer decision time. Bystanders acted more promptly when men than when women fell ill. Public knowledge of MI symptoms, and how to act properly, still seems insufficient.

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BMJ Publishing Group Ltd, 2018. Vol. 8, nr 5, artikkel-id e020211
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Identifikatorer
URN: urn:nbn:se:liu:diva-149740DOI: 10.1136/bmjopen-2017-020211ISI: 000435567200080PubMedID: 29724738OAI: oai:DiVA.org:liu-149740DiVA, id: diva2:1233567
Merknad

Funding Agencies|Medical Research Council of Southeast Sweden (FORSS); County Council of Ostergotland; County Council of Norrbotten

Tilgjengelig fra: 2018-07-18 Laget: 2018-07-18 Sist oppdatert: 2019-05-02bibliografisk kontrollert

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