Evidence map›Paper›PMID 29724738›Full record

Observational studyBMJ open2018

Gender disparities in first medical contact and delay in ST-elevation myocardial infarction: a prospective multicentre Swedish survey study.

Sofia Sederholm Lawesson, Rose-Marie Isaksson, Maria Ericsson, Karin Ängerud, Ingela Thylén, SymTime Study Group

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  13. Sex-based analysis of NSTEMI processes of care and outcomes by hospital: a nationwide cohort study.European heart journal. Quality of care & clinical outcomes · 2024
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  15. Factors Influencing Time to First Medical Contact in Patients with Acute ST-Segment Elevation Myocardial Infarction: A Retrospective Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Sofia Sederholm LawessonDepartment of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Rose-Marie IsakssonDepartment of Research, Norrbotten County Council, Luleå, Sweden.
Maria EricssonDepartment of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Karin ÄngerudDepartment of Nursing, Umeå University, Umeå, Sweden.
Ingela ThylénDepartment of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
SymTime Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesCompare 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.

designCross-sectional study based on medical records and a validated questionnaire. Eligible patients were enrolled within 24 hours after admittance to hospital.

settingPatients were included from November 2012 to January 2014 from five Swedish hospitals with catheterisation facilities 24/7.

participants340 men and 109 women aged between 31 and 95 years completed the survey.

main outcome measuresFMC 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.

resultsWomen more often called an advisory nurse as FMC (28% vs 18%, p=0.02). They had a longer delay until FMC, 90 (IQR 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%, p<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.

conclusionsIn 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.

Indexed as

Health Status DisparitiesTime-to-TreatmentAgedCross-Sectional StudiesFemaleHealth Knowledge, Attitudes, PracticeHumansMaleMiddle AgedOutcome Assessment, Health CareSelf ReportSex FactorsST Elevation Myocardial InfarctionSwedenadult cardiologycoronary heart diseaseischaemic heart diseasemyocardial infarction

Identifiers

PMID29724738
PMCPMC5942442

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.