Coronary artery diseasePrehospital Delay in Patients With Acute Coronary Syndromes (from the Global Registry of Acute Coronary Events [GRACE])
Section snippets
Methods
Full details of the methods of this study have been published and are briefly described.1, 2 The Global Registry of Acute Coronary Events (GRACE) project is designed to reflect an unselected population of patients with ACS irrespective of geographic region. A total of 113 hospitals organized into 18 cluster sites in 14 countries in North and South America, Europe, Australia, and New Zealand are currently collaborating in the GRACE project. Patients with ST-segment elevation myocardial
Results
Overall, there were marked differences in durations of prehospital delay in patients with an ACS according to geographic region (Figure 1). The shortest duration of prehospital delay was observed in patients from study sites in Australia/New Zealand, whereas the longest delays were observed in patients from participating medical centers in Argentina and Brazil. In patients with ST-segment elevation acute MI (AMI), median duration of prehospital delay (3.1 hours) was longest in patients from
Discussion
Results of this large multinational study suggested there was wide geographic variation in care-seeking behavior in patients experiencing an ACS, delay patterns were shortest in those with ST-segment elevation AMI, and a number of factors distinguished patients seeking medical care in a more timely manner compared with those seeking medical care after more prolonged delay, both within and across the different geographic strata under study.
Although considerable success has been achieved in
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Cited by (109)
82-Year-Old Man With Chest Pain and Shortness of Breath
2022, Mayo Clinic ProceedingsThere is little association between prehospital delay, persistent symptoms, and post-discharge healthcare utilization in patients evaluated for acute coronary syndrome
2022, Applied Nursing ResearchCitation Excerpt :Prehospital delay is the largest factor in delayed treatment for ACS (Moser et al., 2006). While population-based studies such as GRACE (Goldberg et al., 2009) and the Worcester Heart Attack Study (Saczynski et al., 2008) found median delay times ranging from 2.2–4.6 h, clinical studies have shown median delay times in presentation to the ED ranging from 1 to 24.4 h (Banks & Dracup, 2007; DeVon et al., 2010; Gorelik et al., 2007; Rosenfeld, 2004). In addition, mortality increases by 7.5% for each 30-min delay in treatment (De Luca et al., 2004; Levine et al., 2015; Mackay et al., 2014; McKee et al., 2013).
Characteristics associated with patient delay during the management of ST-segment elevated myocardial infarction, and the influence of awareness campaigns
2021, Archives of Cardiovascular DiseasesDoor-To-Triage Time in a Canadian Tertiary-Care Center
2021, Journal of Emergency Medicine
The GRACE project was supported by an unrestricted educational grant from Sanofi-Aventis, Paris, France, to the Center for Outcomes Research, University of Massachusetts Medical School, Worcester, Massachusetts.