Prehospital delay and its impact on time to treatment in ST-elevation myocardial infarction

Am J Emerg Med. 2011 May;29(4):396-400. doi: 10.1016/j.ajem.2009.11.006. Epub 2010 Apr 2.


Purposes: We performed this study to assess the impact of pre-hospital time on the patient's outcome.

Procedures: Starting from the symptoms onset, "total time to treatment" was divided into less than or equal to 120 minutes and more than 120 minutes ("pre-hospital time" of ≤ or > 30 minutes respectively). Adverse patient's outcomes were compared in the two subgroups.

Findings: Our patients had a mean age of 63 (±13) years. On-scene time (17.8 ± 9.4 minutes), was the biggest fraction of "pre-hospital time". Comparing the groups with "Total time to treatment" of >120 minutes vs. ±120 minutes ("pre-hospital time" of >30 vs. ≤30 minutes), mortalities were 4 vs. 0 and transfers to a tertiary care facility were 3 vs.1.

Conclusions: Most of the pre-hospital time in STEMI was spent on the scene and we suggest "total time to treatment" as a core measure instead of "door to balloon time".

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary
  • Cohort Studies
  • Electrocardiography
  • Emergency Medical Services / organization & administration*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / mortality
  • Myocardial Infarction / therapy*
  • Retrospective Studies
  • Survival Rate
  • Time Factors