Document Type

Conference Proceeding

Publication Date

5-2024

Publication Title

Academic Emergency Medicine

Abstract

Background and Objectives: Detection of ST-segment elevation myocardial infarctions (STEMI) are dependent on early acquisition of an ECG. American Heart Association guidelines require performing an ECG within 10 min for patients presenting with symptoms warranting STEMI screening. A delay in ECG acquisition causes delays in diagnosis and treatment, which is associated with worsened outcomes. However, previous work has shown there is limited success at achieving a door to ECG (D2E) time of Methods: This is a retrospective chart review study in which D2E time was measured for patients positive for STEMI ECG screening criteria in a large health system with 11 EDs and >500,000 ED visits per year using standardized, evidence-based STEMI ECG screening criteria based on chief complaints at various age cutoffs. We included walk-in patients that received at least one ECG in the ED from 1/1/2021 to 7/31/2023. Success rate was defined as the proportion of screen positive patients with D2E Results: We had 124,848 patient encounters that met inclusion criteria. Of these, 57% were female and 29% were Black. We found that in STEMI ECG screen positive female patients, only 47.6% received their ECG within 10 min compared to 52% of males. The odds of successfully receiving an ECG within 10 min for male patients was significantly higher than females (OR 1.193, 95% CI [1.166–1.22]). We also found that only 48.2% and 45.9% of Asian and Black patients respectively had a D2E within 10 min, compared to 51% of White patients. The odds of successfully receiving an ECG within 10 min for white patients was significantly higher than Asian and Black patients (OR 0.894, 95% CI [0.825–0.969] and OR 0.814, 95% CI [0.794–0.834], respectively). Conclusion: Female, Asian and Black patients are at higher risk of delayed D2E. Future studies should focus on optimizing screening criteria for possible STEMI to ensure D2E is equitable based on sex and race

Volume

31

Issue

S1

First Page

95

Comments

Society for Academic Emergency Medicine SAEM Annual Meeting, May 14-17, 2024, Phoenix, AZ

DOI

10.1111/acem.14533

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