[Accessibility to health care of diabetic patients with acute coronary syndrome ST-segment elevation]. / Accesibilidad al sistema sanitario de los pacientes diabéticos con síndrome coronario agudo con elevación del segmento ST.
Med Intensiva
; 40(2): 90-5, 2016 Mar.
Article
em Es
| MEDLINE
| ID: mdl-26008217
ABSTRACT
OBJECTIVES:
To measure accessibility to health care among diabetic patients and analyze whether differences in delay explain differences in hospital mortality.METHODS:
A retrospective cohort study was conducted in diabetic patients with acute coronary syndrome with ST-segment elevation included in the ARIAM-SEMICYUC registry (2010-2013). Crude and adjusted analyses were performed using unconditional logistic regression.RESULTS:
A total of 4817 patients were analyzed, of whom 1070 (22.2%) were diabetics. No differences were found in access to health care between diabetic and non-diabetic patients. Diabetic patients presented with longer patient delay (90 min vs. 75 min; p=.004) and prehospital delay (150 min vs. 130 min; p=.002). Once the health system was contacted, diabetic patients had a lower reperfusion rate (50% vs. 57.7%; p<.001), but no longer delay in treatment was observed compared with the non-diabetic individuals. Diabetic patients have greater in-hospital mortality (12.5 vs. 6%; p <.001), though neither patient delay nor prehospital delay were identified as independent predictors of in-hospital mortality.CONCLUSIONS:
Diabetic patients had a longer delay in access to health care, though such delay was not independently related to increased mortality.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Diabetes Mellitus
/
Síndrome Coronariana Aguda
/
Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Humans
Idioma:
Es
Revista:
Med Intensiva
Ano de publicação:
2016
Tipo de documento:
Article