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Temporal and Provincial Variation in Ambulance Use Among Patients Who Present to Acute Care Hospitals With ST-Elevation Myocardial Infarction.

Publication ,  Journal Article
Kaul, P; Welsh, RC; Liu, W; Savu, A; Weiss, DR; Armstrong, PW
Published in: Can J Cardiol
August 2016

BACKGROUND: At the first sign or symptoms consistent with an ST-elevation myocardial infarction (STEMI), patients are encouraged to call 9-1-1 and activate emergency medical services immediately. We examined: (1) temporal trends and provincial variations in the proportion of STEMI patients who arrive by ambulance; and (2) the association between patient demographic and clinical characteristics and ambulance use. METHODS: Hospital data for all patients 20 years or older who presented with a primary diagnosis of STEMI between April 1, 2007 and March 31, 2013 in all provinces, except Quebec, were examined to identify ambulance use rates according to year and province. RESULTS: Among 67,232 STEMI hospitalizations (for 66,008 unique patients), the proportion of patients who presented by ambulance increased from 60% in fiscal year (FY) 2007 to 68% in FY 2012. In FY 2012, Alberta had the highest percentage of ambulance use (76%), followed by New Brunswick (73%) and Ontario (72%). At the province level, a higher rate of ambulance use was negatively correlated (r = -0.72; P = 0.04) with in-hospital mortality rate. Patients who presented by ambulance were older and more likely to be female. Self-presenters were more likely to be urban dwellers and present during work hours. Provincial differences in ambulance use remained after adjustment for patient characteristics, overall, and within specific patient subgroups. CONCLUSIONS: The use of ambulance services among patients who presented with STEMI in Canada has increased significantly over the past 5 years, although significant interprovincial variation remains.

Duke Scholars

Published In

Can J Cardiol

DOI

EISSN

1916-7075

Publication Date

August 2016

Volume

32

Issue

8

Start / End Page

949 / 955

Location

England

Related Subject Headings

  • Thrombolytic Therapy
  • Social Class
  • Sex Distribution
  • ST Elevation Myocardial Infarction
  • Rural Population
  • Percutaneous Coronary Intervention
  • Middle Aged
  • Male
  • Humans
  • Hospital Mortality
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kaul, P., Welsh, R. C., Liu, W., Savu, A., Weiss, D. R., & Armstrong, P. W. (2016). Temporal and Provincial Variation in Ambulance Use Among Patients Who Present to Acute Care Hospitals With ST-Elevation Myocardial Infarction. Can J Cardiol, 32(8), 949–955. https://doi.org/10.1016/j.cjca.2015.09.017
Kaul, Padma, Robert C. Welsh, Wei Liu, Anamaria Savu, Dale R. Weiss, and Paul W. Armstrong. “Temporal and Provincial Variation in Ambulance Use Among Patients Who Present to Acute Care Hospitals With ST-Elevation Myocardial Infarction.Can J Cardiol 32, no. 8 (August 2016): 949–55. https://doi.org/10.1016/j.cjca.2015.09.017.
Kaul P, Welsh RC, Liu W, Savu A, Weiss DR, Armstrong PW. Temporal and Provincial Variation in Ambulance Use Among Patients Who Present to Acute Care Hospitals With ST-Elevation Myocardial Infarction. Can J Cardiol. 2016 Aug;32(8):949–55.
Kaul, Padma, et al. “Temporal and Provincial Variation in Ambulance Use Among Patients Who Present to Acute Care Hospitals With ST-Elevation Myocardial Infarction.Can J Cardiol, vol. 32, no. 8, Aug. 2016, pp. 949–55. Pubmed, doi:10.1016/j.cjca.2015.09.017.
Kaul P, Welsh RC, Liu W, Savu A, Weiss DR, Armstrong PW. Temporal and Provincial Variation in Ambulance Use Among Patients Who Present to Acute Care Hospitals With ST-Elevation Myocardial Infarction. Can J Cardiol. 2016 Aug;32(8):949–955.
Journal cover image

Published In

Can J Cardiol

DOI

EISSN

1916-7075

Publication Date

August 2016

Volume

32

Issue

8

Start / End Page

949 / 955

Location

England

Related Subject Headings

  • Thrombolytic Therapy
  • Social Class
  • Sex Distribution
  • ST Elevation Myocardial Infarction
  • Rural Population
  • Percutaneous Coronary Intervention
  • Middle Aged
  • Male
  • Humans
  • Hospital Mortality