Shen, Jeremiah Ding Deck
(2018)
Association of ambulance response time and major adverse cardiac events in acute coronary syndrome.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: A common tenet in emergency medical service is that a faster response
time equates to a better outcome in patients with acute coronary syndrome (ACS). We
explored the association between ambulance response time (ART) and major adverse
cardiac events (MACE) in patients diagnosed of ACS in Malaysia. Methods: This
study was a retrospective cohort analysis conducted from 2014 until 2016 involving two
emergency medical services (EMS) in Malaysia. Adult patients diagnosed with ACS
and utilized the EMS to come to hospital were followed up to assess MACE within 30
and 90 days from the primary event. Multivariable logistic regression analysis was
performed to evaluate the interaction between ART and MACE. Results: One hundred
patients with an average age of 59.7 (SD=12.7) years old were included in the analysis.
The average ART was 21.7 (SD=10.4) minutes. 29 patients developed MACE at 30
days and 40 patients developed MACE at 90 days post ACS. No significant association
was found between ART and occurrence of MACE 30 and 90 days post ACS (OR=
0.99; 95% CI: 0.95, 1.03; P=0.679 and OR=0.98; 95% CI: 0.95, 1.02; P=0.446
respectively). Conclusion: ART was not significantly associated with MACE after both
30 and 90 days onset of ACS. This underscores the need for not driving ambulances
with high speeds when responding to ACS cases.
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