Editorial
Patient delay in calling for help: the weakest link in the chain of survival?
| The first 150 words of the full text of this article appear below. |
On average, one third of cases of myocardial infarction (MI) are fatal before hospitalisation and most of the deaths have occurred within four hours of the onset of acute symptoms.1 The very high pre-hospital mortality is particularly a problem in younger patients as over 90% of the deaths in those less than 55 years old occur before they come to hospital, whereas in the 70-74 year age group 67% of the deaths occur outside hospital.2 A greater emphasis on pre-hospital care has more potential for reducing the mortality from acute MI than further development of hospital based treatments.
The delay between the time of onset of symptoms and the time at which
the patient comes under medical attention is a major determinant of
prognosis in acute MI; the largest single component of the delay is
that taken by the patient deciding to summon help.3 In the
UK heart attack study, lives
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