Sökning: onr:"swepub:oai:DiVA.org:lnu-62758" >
Determinants of pre...
Determinants of pre-hospital pharmacological intervention and its association with outcome in acute myocardial infarction
-
- Strandmark, Rasmus (författare)
- Sahlgrenska University Hospital, Sweden
-
- Herlitz, Johan (författare)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHopsen,Sahlgrenska University Hospital, Sweden;University of Borås, Sweden
-
- Axelsson, Christer (författare)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHospen,University of Borås, Sweden
-
visa fler...
-
- Claesson, Andreas (författare)
- Karolinska Institutet, Sweden
-
- Bremer, Anders, 1957- (författare)
- Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,PreHospen - Centrum för prehospital forskning,University of Borås, Sweden
-
- Karlsson, Thomas, 1956 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för arbets-och miljömedicin,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa, enheten för hälsometri,Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine,Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics,University of Gothenburg, Sweden
-
- Jimenez-Herrera, Maria (författare)
- Universitat Rovira i Virgili, Spain
-
- Ravn-Fischer, Annica, 1974 (författare)
- Sahlgrenska University Hospital, Sweden
-
visa färre...
-
(creator_code:org_t)
- 2015-12-01
- 2015
- Engelska.
-
Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 23:105
- Relaterad länk:
-
https://doi.org/10.1...
-
visa fler...
-
https://sjtrem.biome...
-
https://urn.kb.se/re...
-
https://doi.org/10.1...
-
https://urn.kb.se/re...
-
https://urn.kb.se/re...
-
http://kipublication...
-
https://gup.ub.gu.se...
-
visa färre...
Abstract
Ämnesord
Stäng
- Background: The aim of this study was a) To identify predictors of the use of aspirin in the pre-hospital setting in acute myocardial infarction (AMI) and b) To analyze whether the use of any of the recommended medications was associated with outcome.Methods: All patients with a final diagnosis of AMI, transported by the Emergency Medical Services (EMS) and admitted to the coronary care unit at Sahlgrenska University Hospital in Gothenburg, Sweden, in 2009–2011, were included.Results: 1,726 patients were included. 58 % received aspirin by the EMS. Ischemic heart disease (IHD) was suspected in 84 %. Among patients who did not receive aspirin IHD was still suspected in 67 %. Among patients in whom IHD was suspected, and who were not on chronic treatment with aspirin the following predicted its pre-hospital use: a) age (odds ratio 0.98; 95 % confidence interval (CI) 0.96–0.99); b) a history of myocardial infarction (2.21; 1.21–4.04); c) priority given by EMS (8.07; 5.42–12.02); d) ST-elevation on ECG on admission to hospital (2.22; 1.50–3.29); e) oxygen saturation > 90 % (3.37; 1.81–6.27). After adjusting for confounders among patients who were not on chronic aspirin, only nitroglycerin of the recommended medications was associated with a reduced risk of death within 1 year (hazard ratio 0.40; 95 % CI 0.23–0.70).Conclusions: Less than six out of ten patients with AMI received pre-hospital aspirin. Five clinical factors were independently associated with the pre-hospital administration of aspirin. This suggests that the decision to treat is multifactorial, and it highlights the lack of accurate diagnostic tools in the pre-hospital environment. Nitroglycerin was independently associated with a reduced risk of death, suggesting that we select the use for a low-risk cohort.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- Chest pain
- Myocardial infarction
- Emergency medical services
- Early medical intervention
- Aspirin
- Nitroglycerin
- Medicin
- Medicine
- Människan i vården
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas