• A Baeza-Román, E de Miguel-Balsa, J Latour-Pérez, V Díaz de Antoñana-Saez, J Arguedas-Cervera, E Mira-Sánchez, C J Fernández-González, M Rico-Sala, M Lafuente-Mateo, and Grupo ARIAM-SEMICYUC.
• Unidad de Cuidados Intensivos, Hospital General Universitario de Elche, Elche, España. Electronic address: anna.baeza@coma.es.
• Med Intensiva. 2016 Mar 1; 40 (2): 90-5.

ObjectivesTo measure accessibility to health care among diabetic patients and analyze whether differences in delay explain differences in hospital mortality.MethodsA 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.ResultsA 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.ConclusionsDiabetic patients had a longer delay in access to health care, though such delay was not independently related to increased mortality.Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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