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Safety and delay time in prehospital thrombolysis of acute myocardial infarction in urban and rural areas in Sweden
[external]. (Prehospital akutsjukvård)
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2003 (English)In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 21, no 4, 263-270 p.Article in journal (Refereed) Published
Abstract [en]

Sixteen hospitals in Sweden, including those in urban and more sparsely populated areas, and the associated ambulance organizations were enrolled in a prospective evaluation of the feasibility of treating patients with a ST-elevation infarction with a thrombolytic agent (reteplase) before hospital admission. A physician staffed the ambulances in 1% of cases, a nurse in 67%, and a staff nurse in 32% of cases. In all, 64 patients in urban areas and 90 patients in rural areas were included. The occurrence of complications before hospital admission was low and similar in the 2 groups. The median interval between the onset of symptoms and the start of thrombolysis was 1 hour 44 minutes in urban areas versus 2 hours 14 minutes in rural areas (P = 0.03). The median arrival time (interval between onset of symptoms and arrival of the ambulance) tended to be shorter in urban areas (1 hr 10 min vs 1 hr 33 min; not significant) and the median interval between the arrival of the ambulance and the start of thrombolysis was shorter in urban areas (27 min vs 36 min; P < 0.0001). When comparing urban areas with the least-populated rural areas, differences in various delay times became even more marked. Patients in urban areas had a higher ejection fraction and fewer symptoms of heart failure after 30 days and a lower 1-year mortality.

Place, publisher, year, edition, pages
W.B. Saunders Co. , 2003. Vol. 21, no 4, 263-270 p.
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Medical and Health Sciences
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URN: urn:nbn:se:hb:diva-7967DOI: 10.1016/S0735-6757(03)00040-8Local ID: 2320/8760OAI: oai:DiVA.org:hb-7967DiVA: diva2:888850
Available from: 2015-12-22 Created: 2015-12-22 Last updated: 2017-09-26Bibliographically approved

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Herlitz, Johan

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CiteExportLink to record
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Citation style
  • apa
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  • vancouver
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More styles
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  • de-DE
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  • nn-NB
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  • Other locale
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Output format
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