Factors Related to Use of Emergency Medical Services in Patients with Acute ST Segment Elevation Myocardial Infarction

Objective To explore the choice of transportation mode to hospital in patients experiencing acute ST elevation myocardial infarction(STEMI)and ascertain the factors that may influence the use of Emergency Medical Service(EMS)in patients with acute STEMI.Methods 412 consective patients confirmed STEMI from Febury 2006 to January 2009 were divided into two groups based on the use of EMS:EMS group and self-transportation group.A questionnaire developed to assess demographic characteristics,Clinical factors and psychological factors.Paients were interviewed within 72 hours of admission to 2 hospitals.Results EMS was used in 26.90% of patients with STEMI,actors associated with EMS in a univariate analysis were history of coronary artery disease hospitalization,nausea,vomiting,dizziness,collapse,sudden onset,progressive symptoms,"waited and see","worried about to bother others",times of contacting physician before arrived at study hospital,thinking it was a cardiac origin disease.In a multivariate analysis,contact physician(0.49,0.33～0.73),nausea(2.57,1.58～4.19),collapse(5.49,2.05～14.70),progressive symptoms(1.98,1.19～3.29),"waited and see"(0.55,0.34～0.89)and contributed symptoms to cardiac disease(2.37,1.44～3.91).Conclusion Only one fourth of patients with STEMI were transported to the hospital by EMS,they view the EMS as an option for transportation to hospital only if they feel really sick.For that reason,it needs to be made well known to the public that EMS are not only a mode of transport,but also provide diagnostics and treatment.