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Patients with suspected myocardial infarction: effect of mode of referral on admission time to a coronary care unit.
Br J Gen Pract. 1992 Apr; 42(357):145-7.BJ

Abstract

The aim of this prospective study was to determine the delay between the onset of symptoms and arrival in the coronary care unit of patients with suspected acute myocardial infarction, and the relative contribution to the total delay of patient delay, method of referral (self referral or general practitioner referral) and delay in the hospital before reaching the coronary care unit. All patients admitted with chest pain to the coronary care unit at Dudley Road Hospital, Birmingham, over the six month period April-September 1989 were included in the study. Ninety five patients were referred by their general practitioner and 107 patients attended the accident and emergency department directly or arrived by ambulance without contacting their general practitioner. The proportion of self referred and general practitioner referred patients with acute myocardial infarction, angina and non-cardiac chest pain were not significantly different. The total delay was significantly longer for patients who had been referred by their general practitioner (median 5.3 hours) than for self referrals (3.2 hours, P less than 0.001), with a significantly higher proportion of self referrals arriving at the coronary care unit within six hours of the onset of symptoms (77% versus 54%, P less than 0.01). Among general practitioner referrals, initial patient delay accounted for a median of 2.5 hours and the general practitioner's response time for a median of 1.1 hours. The delay in hospital was similar for both groups of patients. In inner city areas, self referral may result in considerably less delay than general practitioner referral allowing a greater proportion of patients to receive effective thrombolytic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Department of Cardiology, Dudley Road Hospital, Birmingham.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1586549

Citation

Ahmad, R A., et al. "Patients With Suspected Myocardial Infarction: Effect of Mode of Referral On Admission Time to a Coronary Care Unit." The British Journal of General Practice : the Journal of the Royal College of General Practitioners, vol. 42, no. 357, 1992, pp. 145-7.
Ahmad RA, Bond S, Burke J, et al. Patients with suspected myocardial infarction: effect of mode of referral on admission time to a coronary care unit. Br J Gen Pract. 1992;42(357):145-7.
Ahmad, R. A., Bond, S., Burke, J., Singh, S. P., & Watson, R. D. (1992). Patients with suspected myocardial infarction: effect of mode of referral on admission time to a coronary care unit. The British Journal of General Practice : the Journal of the Royal College of General Practitioners, 42(357), 145-7.
Ahmad RA, et al. Patients With Suspected Myocardial Infarction: Effect of Mode of Referral On Admission Time to a Coronary Care Unit. Br J Gen Pract. 1992;42(357):145-7. PubMed PMID: 1586549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Patients with suspected myocardial infarction: effect of mode of referral on admission time to a coronary care unit. AU - Ahmad,R A, AU - Bond,S, AU - Burke,J, AU - Singh,S P, AU - Watson,R D, PY - 1992/4/1/pubmed PY - 1992/4/1/medline PY - 1992/4/1/entrez SP - 145 EP - 7 JF - The British journal of general practice : the journal of the Royal College of General Practitioners JO - Br J Gen Pract VL - 42 IS - 357 N2 - The aim of this prospective study was to determine the delay between the onset of symptoms and arrival in the coronary care unit of patients with suspected acute myocardial infarction, and the relative contribution to the total delay of patient delay, method of referral (self referral or general practitioner referral) and delay in the hospital before reaching the coronary care unit. All patients admitted with chest pain to the coronary care unit at Dudley Road Hospital, Birmingham, over the six month period April-September 1989 were included in the study. Ninety five patients were referred by their general practitioner and 107 patients attended the accident and emergency department directly or arrived by ambulance without contacting their general practitioner. The proportion of self referred and general practitioner referred patients with acute myocardial infarction, angina and non-cardiac chest pain were not significantly different. The total delay was significantly longer for patients who had been referred by their general practitioner (median 5.3 hours) than for self referrals (3.2 hours, P less than 0.001), with a significantly higher proportion of self referrals arriving at the coronary care unit within six hours of the onset of symptoms (77% versus 54%, P less than 0.01). Among general practitioner referrals, initial patient delay accounted for a median of 2.5 hours and the general practitioner's response time for a median of 1.1 hours. The delay in hospital was similar for both groups of patients. In inner city areas, self referral may result in considerably less delay than general practitioner referral allowing a greater proportion of patients to receive effective thrombolytic therapy.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0960-1643 UR - https://www.unboundmedicine.com/medline/citation/1586549/Patients_with_suspected_myocardial_infarction:_effect_of_mode_of_referral_on_admission_time_to_a_coronary_care_unit_ L2 - https://bjgp.org/cgi/pmidlookup?view=long&pmid=1586549 DB - PRIME DP - Unbound Medicine ER -