Władysław Witczak, Stanisław Tokarski
Med Sci Monit 1999; 5(6): EP1163-1167
The aim of this study was to analyse the pre-hospital mortality rate due to acute myocardial infarction, as well as to assess the incidence of first-aid administered by accidental subjects in the case of myocardial infarction complicated by sudden cardiac arrest and the effectiveness of these resuscitation procedures. The study group comprised 3317 patients with an acute myocardial infarction, including 2561 men and 756 women. Data concerning patients who were hospitalized or died during the pre-hospital phase of an acute myocardial infarction were collected on the basis of retrospective medical record analyses. Acute myocardial infarction incidence rates consisted of the sum of the number of patients admitted to the hospital and those who died during the out-of-hospital period. Information concerning the incidence of first-aid administered by accidental subjects and the effectiveness of resuscition procedures in myocardial infarction complicated by sudden cardiac arrest were derived from ambulance data. During the study period we noted 3317 cases of acute myocardial infarction in the population of middle-eastern Poland. 796 patients died during the pre-hospital period, which amounted to 23.9% of all subjects comprised in the study. The pre-hospital mortality rate due to acute myocardial infarction was significantly higher in men compared to women (p < 0.0001) and amounted to 17%. Sudden cardiac arrest due to acute myocardial infarcions was observed in 243 patients. 37 (15.2%) study group patients received life support procedures undertaken by accidental subjects. Data analysis revealed a statistically significant favourable correlation between first-aid administered to patients by accidental subjects and the effectiveness of all resuscitation procedures (p < 0.001). The overall percentage of patients who died during the pre-hospital period amounted to 24. Men died more often than women prior to the arrival of an ambulance. First-aid was applied by accidental subjects in as few as 13% of cases. The effectiveness of all resuscitation procedures amounted to 35% and was significantly higher in patients who received basic life support from accidental subjects.
Keywords: acute myocardial infarction, pre-hospital mortality, Resuscitation, first aid during the pre-hospital period