Comparison of the hospital arrival time and differences in pain quality between diabetic and non-diabetic STEMI patients.

ABSTRACT

The aim of our study was to determine whether diabetic ST segment elevation myocardial infarction (STEMI) patients arrive in the emergency room (ER) later than non-diabetics, compare the differences in pain quality and quantity between those groups, and measure differences in the outcome after an index hospitalization. A total of 266 patients with first presentation of STEMI were included in our study during a period of two years, 62 with diabetes and 204 without diabetes type 2. Pain intensity and quality at admission were measured using a McGill short form questionnaire. Diabetic patients did not arrive significantly later than non-diabetic (χ²; p = 0.105). Most diabetic patients described their pain as "slight" or "none" (χ²; p < 0.01), while most non-diabetic patients graded their pain as "moderate" or "severe" (χ²; p < 0.01). The quality of pain tended to be more distinct in non-diabetic patients, while diabetic patients reported mainly shortness of breath (χ²; p < 0.01). Diabetic patients were more likely to suffer a multi-vessel disease (χ²; p < 0.01), especially in the late arrival group. Therefore, cautious evaluation of diabetic patients and adequate education of target population could improve overall survival while well-organized care like a primary PCI Network program could significantly reduce CV mortality.