Treatment delay in primary PCI in relation to marital status and distance from acute medical care
Bibliographic record
Abstract
Purpose: Total ischaemic (TI) time following the onset of chest pain is a major determinant of outcome in STEMI. Delay in seeking medical attention (symptom to call time; STC) may contribute significantly to TI time. We assessed whether marital status or distance from nearest medical care (geographical isolation) influenced STC or TI time. Methods: Registry data for PPCI from March 2008 to November 2011 from a large UK tertiary centre serving urban, suburban and rural areas were analysed. Marital status (married/partner vs. others [single, divorced, widowed]) was established. Geographical isolation was defined as the driving time between the patient's home address and nearest hospital (<10mins, 11-20mins and >20 mins). Chest pain onset, call time, 1st device time and TI times were determined. STC time of ≤/>30 minutes, and TI time ≤/>180 minutes were defined a priori as binary outcomes. Multivariable logistic regression was used to define the importance of marital status and time to nearest hospital, adjusting for important covariates including age, sex, infarct location, risk factors, medical history, time of day, direct admission and shock. Results: Mean age was 63.3 (SD 13.4) and 737 (29.4%) were female. 1333 (64.9%) patients were married/with partner. 771 (33.6%) patients lived <10mins from hospital, 1123 (48.9%) 11-20 mins and 403 (17.5%) >20 mins. 1,760 and 1,823 patients were included in the final STC and TI analyses respectively. 1257 (71.4%) patients had a STC time of >30 minutes and and 809 (44.4%) TI >180 mins. Following multivariable analysis, patients who were married/with partner were more likely to seek help within 30 minutes of symptom onset and have TI time of <180 mins. Geographical isolation was not associated with longer STC, but there was an association of borderline significance with longer TI time (table). Table 1 Conclusions: Non-married patients were more likely to delay seeking medical attention and had longer TI times after STEMI onset. In this UK study, geographical location was not associated with STC time, but longer transit times to PPCI centre may influence TI time.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".