QCOR: Inability to Understand English Delays MI Treatment

Symptom onset to presentation time significantly longer in patients who do not speak English

FRIDAY, May 13 (HealthDay News) Patients' inability to comprehend English delays symptom onset to presentation time (S2PT) among patients presenting with ST-segment elevation myocardial infarction (STEMI), according to a study presented at the American Heart Association's Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke 2011 Scientific Sessions, held from May 12 to 14 in Washington, D.C.

Dayana J. Eslava, M.D., from the Beth Israel Medical Center in New York City, and colleagues investigated whether a patient's ability to understand English impacts the S2PT. Based on a patient's account of symptom onset, the S2PT on the day of the infarct for 210 patients with STEMI was recorded. Through telephone interviews conducted during routine follow-up, they identified 176 participants with either some comprehension or fluency in English (E) and 34 with no English comprehension (non-E). The non-E patients spoke Spanish (65 percent), Russian or Chinese (6 percent each), and other languages (23 percent).

The investigators found that non-E patients had a significantly higher S2PT compared to E patients, with increased odds observed among non-E patients with a longer S2PT (adjusted odds ratio for S2PT > 120 minutes, 2.17; P = 0.04). Even after adjusting for variables like age, sex, ethnicity, level of education, and comorbidities, this association remained constant.

"S2PT is strongly influenced by a patient's ability to comprehend English. This information emphasizes the need for more aggressive 'multi-lingual' educational outreach and the use of multi-lingual emergency lines in an effort to decrease total ischemic time during STEMI," the authors write.

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