19.01.17

There may be serious health consequences delaying a 9-1-1 call for patients with symptoms of myocardial infection

Patients with myocardial infarction are still too slow to react to initial symptoms. The more delay in primary percutaneous intervention, the higher the risk of part of the heart muscle dying. As a heart specialist puts it: "Time is muscle", because the risk of heart failure and subsequent death is reduced by fast treatment intervention.

In 2006, Denmark introduced a system where patients are diagnosed in the ambulance. Patients with myocardial infarction are transported to a hospital with 24-hour acute primary percutaneous intervention facilities. However, it is paramount that patients call 9-1-1 immediately when initial symptoms appear.

The duration from symptom onset to calling emergency services was recently investigated. Between 2003 and 2009, 5,786 patients were admitted with a serious myocardial infarction at three Danish university hospitals in Aarhus, Odense and Aalborg.

In 2009, the average duration from symptom onset to the emergency call was 1 hour and 25 minutes. Even though this was 15 minutes faster compared with 2003, there is still a long way before reaching the goal that all patients react as fast as possible and within a time window of two hours after onset of the first symptoms.

The study made by Aarhus University Hospital and Aarhus University investigated which groups of patients particularly delaying the 9-1-1 call. The study showed that particularly women, elderly people, diabetics and people having symptoms at night called emergency services later.

-It should be considered if targeted information to these groups of patients could make them contact health services sooner, says Christel Gry Aagren Nielsen, MSc in Health Science and nurse at Department of Cardiology at Aarhus University Hospital.

-We know from general campaigns that it is hard to reach everybody. A more direct effort in selected groups could make an important difference for these people and reduce the number of readmissions caused by complications to myocardial infarction.

Behind the research result:

Study type: Registry-based study, historical follow-up

Collaborators: Odense University Hospital and Aalborg University Hospital

External financing: Novo Nordisk Foundation

Published in: EHJ Acute Cardiovascular Care 2016; Nov. 30 online

Conflicts of interest: None

Read the scientific article:

Nielsen CG, Laut KG, Jensen LO, Ravkilde J, Terkelsen CJ, Kristensen SD. Patient delay in patients with ST-elevation myocardial infarction: Time patterns and predictors for a prolonged delay. Eur Heart J AcuteCardiovasc Care. 2016 Nov. 30.

Further information:

Christel Gry Aagren Nielsen

Department of Cardiology

Aarhus University Hospital

Tel.: +45 7845 2213, Mobile: +45 2511 5982

E-mail: chisnils@rm.dk