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Gender and Age Differences Associated With Prehospital Delay in Chinese Patients Presenting With ST-Elevation Myocardial Infarction

Zhang, Bo MD, PhD; Zhang, Wei MD, PhD; Huang, Rongchong MD, PhD; Zhu, Hao MD; Liu, Jun MD; Jiang, Daming MD; Ren, Lina MD, PhD; Zhou, Xuchen MD, PhD; Qi, Guoxian MD, PhD

Journal of Cardiovascular Nursing: March/April 2016 - Volume 31 - Issue 2 - p 142–150
doi: 10.1097/JCN.0000000000000219
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Background and Objectives: A limited number of studies have examined the interaction between gender and age with regard to extent of prehospital delay. Our aim was to examine gender and age differences associated with prehospital delay in Chinese patients presenting with ST-elevation myocardial infarction (STEMI).

Methods: A total of consecutive 1429 records from patients presenting with STEMI were analyzed between June 1, 2009, and June 1, 2010. We compared hospital care data by gender and age for inpatients with acute STEMI presenting within 24 hours of symptom onset.

Results: The overall median duration of prehospital delay was 150 minutes (mean, 266 minutes). For patients 54 years or younger, 55 to 64 years old, and 75 years or older, women were more likely to experience longer delays compared with men (P < .05) even after controlling for medical history and risk factors. For male patients, compared with groups 54 years or younger, with the exception of men 55 to 64 years old, older male patients were more likely to have greater delays (P < .05) even after controlling for medical history and risk factors. However, after controlling for other variables, these gender and age differences in prehospital delay were no longer statistically significant. Among patients 65 to 74 years old, there were no gender differences in prehospital delay. Among female patients, there were no age differences in prehospital delay.

Conclusions: Male elderly patients (aged ≥65 years) and women (aged ≤64 and ≥75 years) with STEMI were more likely to delay seeking timely medical care. These gender and age differences were explained by different education, stable income, medical insurance, typical chest pain, and cognition toward heart diseases.

Bo Zhang, MD, PhD Associate Professor, Department of Cardiology, First Affiliated Hospital, Dalian Medical University, Dalian, China.

Wei Zhang, MD, PhD Associate Professor, Department of Geriatrics, First Affiliated Hospital, Dalian Medical University, Dalian, China.

Rongchong Huang, MD, PhD Professor, Department of Cardiology, First Affiliated Hospital, Dalian Medical University, Dalian, China.

Hao Zhu, MD Professor, Department of Cardiology, First Affiliated Hospital, Dalian Medical University, Dalian, China.

Jun Liu, MD Professor, Department of Cardiology, First Affiliated Hospital, Dalian Medical University, Dalian, China.

Daming Jiang, MD Associate Professor, Department of Cardiology, Dandong Center Hospital, Dangdong, China.

Lina Ren, MD, PhD Fellow, Department of Cardiology, First Affiliated Hospital, China Medical University, Shenyang, China.

Xuchen Zhou, MD, PhD Professor, Department of Cardiology, First Affiliated Hospital, Dalian Medical University, Dalian, China.

Guoxian Qi, MD, PHD Professor, Department of Cardiology, First Affiliated Hospital, China Medical University, Shenyang, China.

This work was Supported by Science and Technology Planning Project of Liaoning Province, China (no. 2008225009-15).

This study was approved by the ethics committee of China Medical University.

The authors have no conflicts of interest to disclose.

Correspondence Xuchen Zhou, MD, PhD, Department of Cardiology, First Affiliated Hospital, Dalian Medical University, Dalian 116011, China (zhouxuchen@hotmail.com); Guoxian Qi, MD, PhD, Department of Cardiology, First Affiliated Hospital, China Medical University, Shenyang 110001, China (zhonghb100@qq.com).

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