Purpose of the study: The aim of this study was to investigate the effect of pre-hospital system delays of emergency medical services (EMS) on in-hospital mortality in ST-segment elevation myocardial infarction (STEMI) patients.
Materials and methods: The pre-hospital and hospital medical records of STEMI patients who used EMS transportation and were treated with primary percutaneous coronary intervention (pPCI) within 60 minutes after admission to the Department of Cardiology, St. Raphael's Hospital, Krakow, Poland, between January 2011 and December 2015 (excluding 2013) were retrospectively reviewed.
Results: Among 515 respondents meeting this criteria 26 (5.0%) died in the hospital. In the one-dimensional model the duration of prehospital procedures was significantly related to death. Extending this time by 1 minute increased the chances death by 2% (95% CI: 1,002-1,04). Multidimensional regression models were performed for all pre-hospital procedures tested. The presented results include the administration of antiplatelet/anticoagulant drugs (heparin, clopidogrel or both) because they were significantly associated with increased death chance in earlier multivariable models. After taking into account the influence of age, sex, presence of diabetes, hypertension, hypercholesterolemia, renal failure, shock and the administration of drugs (heparin, clopidogrel) in the model, the time from first medical contact (FMC) to patient hospital admission was not significantly related to in-hospital death (Table 1).
Conclusions: Prolonged pre-hospital management is not significantly associated with in-hospital mortality rate.