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dc.contributor.authorUleberg, Bård Erling
dc.contributor.authorBønaa, Kaare Harald
dc.contributor.authorGovatsmark, Ragna Elise Støre
dc.contributor.authorOlsen, Frank
dc.contributor.authorJacobsen, Bjarne K.
dc.contributor.authorStensland, Eva
dc.contributor.authorHauglann, Beate Kristin
dc.contributor.authorVonen, Barthold Gisle
dc.contributor.authorFørde, Olav Helge
dc.date.accessioned2024-08-27T08:45:05Z
dc.date.available2024-08-27T08:45:05Z
dc.date.issued2024-02-17
dc.description.abstractObjectives This study aimed to investigate determinants of reperfusion within recommended time limits (timely reperfusion) for ST-segment elevation myocardial infarction patients, exploring the impact of geography, patient characteristics and socio-economy. Design National register-based cohort study. Setting Multilevel logistic regression models were applied to examine the associations between timely reperfusion and residency in hospital referral areas and municipalities, patient characteristics, and socio-economy. Participants 7607 Norwegian ST-segment elevation myocardial infarction patients registered in the Norwegian Registry of Myocardial Infarction during 2015–2018. Main outcome measures The odds of timely reperfusion by primary percutaneous coronary intervention (PCI) or fibrinolysis. Results Among 7607 ST-segment elevation myocardial infarction patients in Norway, 56% received timely reperfusion. The Norwegian goal is 85%. While 81% of the patients living in the Oslo hospital referral area received timely reperfusion, only 13% of the patients living in Finnmark did so. Patients aged 75–84 years had lower odds of timely reperfusion than patients below 55 years of age (OR 0.73, 95%CI 0.61 to 0.87). Patients with moderate or high comorbidity had lower odds than patients without (OR 0.81, 95%CI 0.68 to 0.95 and OR 0.61, 95%CI 0.44 to 0.84). More than 2 hours from symptom onset to first medical contact gave lower odds than less than 30min (OR 0.63, 95%CI 0.54 to 0.72). 1–2 hours of travel time to a PCI centre (OR 0.39, 95%CI 0.31 to 0.49) and more than 2 hours (OR 0.22, 95%CI 0.16 to 0.30) gave substantially lower odds than less than 1 hour of travel time. Conclusions The varying proportion of patients receiving timely reperfusion across hospital referral areas implies inequity in fundamental healthcare services, not compatible with established Norwegian health policy. The importance of travel time to PCI centre points at the expanded use of prehospital pharmacoinvasive strategy to obtain the goals of timely reperfusion in Norway.en_US
dc.identifier.citationUleberg, Bønaa, Govatsmark, Olsen, Jacobsen, Stensland, Hauglann, Vonen, Førde. Exploring variation in timely reperfusion treatment in ST-segment elevation myocardial infarction in Norway: A national register-based cohort study. BMJ Open. 2024;14(2)en_US
dc.identifier.cristinIDFRIDAID 2252767
dc.identifier.doi10.1136/bmjopen-2023-081301
dc.identifier.issn2044-6055
dc.identifier.urihttps://hdl.handle.net/10037/34430
dc.language.isoengen_US
dc.publisherBMJen_US
dc.relation.journalBMJ Open
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2024 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0en_US
dc.rightsAttribution-NonCommercial 4.0 International (CC BY-NC 4.0)en_US
dc.titleExploring variation in timely reperfusion treatment in ST-segment elevation myocardial infarction in Norway: A national register-based cohort studyen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
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