ArticleJournal of emergencies, trauma, and shock
Factors Influencing the Time to Fibrinolysis in ST-elevation Myocardial Infarction: A Retrospective Observational Study.
Article in Journal of emergencies, trauma, and shock. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Timely reperfusion is critical for managing ST-elevation myocardial infarction (STEMI). We aimed to quantify treatment delays and identify factors associated with delayed fibrinolysis in STEMI patients. Methods: We conducted a retrospective observational study of 174 consecutive adult patients with STEMI who received fibrinolysis at a tertiary academic emergency department in Southern India between May 2023 and January 2024. Data were abstracted from medical records, and detailed prehospital information was obtained through structured telephone interviews. Multivariable logistic regression was used to identify independent predictors of late arrival (>6 h after symptom onset) and delayed door-to-needle (D2N) time (>30 min). Results: The median time from symptom onset to fibrinolysis was 320 min (interquartile range [IQR]: 210-480), driven primarily by a median prehospital delay of 300 min (IQR: 195-464). In contrast, the median D2N time was 15 min (IQR: 10-25), with 82.2% of patients achieving a D2N time of ≤30 min. Independent predictors of late arrival were lack of formal education (adjusted odds ratio [AOR]: 2.31; 95% confidence interval [CI]: 1.21-4.41) and unemployment (AOR: 1.98; 95% CI: 1.04-3.77). Independent predictors of delayed D2N time were a chief complaint other than chest pain (AOR: 8.98; 95% CI: 1.18-68.10), prior coronary artery disease (AOR: 4.86; 95% CI: 1.68-14.09), and consent time >5 min (AOR: 9.51; 95% CI: 2.65-34.16). Conclusions: Despite excellent inhospital performance metrics, the total ischemic time in STEMI patients remains high due to substantial prehospital delays associated with socioeconomic factors.
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