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Comparison of the Hospital Arrival Time and Differences in Pain Quality between Diabetic and Non-Diabetic STEMI Patients

DOI: 10.3390/ijerph120201387, PP. 1387-1396

Keywords: STEMI, diabetes type 2, quality of pain, time of arrival, outcome, prognosis

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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 (χ 2; p = 0.105). Most diabetic patients described their pain as “slight” or “none” (χ 2; p < 0.01), while most non-diabetic patients graded their pain as “moderate” or “severe” (χ 2; p < 0.01). The quality of pain tended to be more distinct in non-diabetic patients, while diabetic patients reported mainly shortness of breath (χ 2; p < 0.01). Diabetic patients were more likely to suffer a multi-vessel disease (χ 2; 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.

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