Factors Associated With Pre-hospital Delay in Patients With Acute Myocardial Infarction

Abstract

BackgroundTreatment of patients with acute myocardial infarction (AMI) is time related, so delay in treatment could affect prognosis. Recognizing pre-hospital or in-hospital delays in initiating treatment and reducing these factors is very efficacious in treatment of these patients.ObjectivesThe aim of this study is evaluate the causes of pre-hospital delay just as other studies on effect of different variables such as socioeconomic and personal factors on pre-hospital delay in with patients with AMI.Materials and MethodsA cross sectional study was carried out on 227 patients with acute myocardial infarction and demographic data, educational level, marital status, type of transfer to hospital and delay in arrival to hospital were recorded.Results35.7% patients arrived during one hour of symptom onset, and 7.9% arrived after 24 hours. Patients having high level education (P = 0.0492) and with a family history of coronary artery disease (P = 0.01) had significantly less delay in arriving to hospital. Age, marital status, gender, and route of transfer to hospital were not related with pre-hospital delay (P > 0.05). Patients thought most common cause of delay in arrival was unawareness of coronary artery disease (38.8%) and self-medication (34.3%).ConclusionsIncreasing awareness of patients about cardiovascular symptoms and their risk factors could be helpful in patient's decision in seeking medical help. So general education via media and primary and middle schools could be helpful.

Predictors of Prehospital Delay in Patients With Acute Myocardial Infarction in Kashan City

“…In other words, attributing the chest pain to noncardiac origins was the most common cause of delay to hospital admission. This finding was consistent with results of Farshidi et al (18) and Rezaei et al (10) who reported that many people were unaware of the symptoms of cardiac diseases. Then, teaching AMI symptoms to people is important.…”

“…In the current study, no significant association was found between the delay time and HTN, AMI, DM, HLP, HF, history of CA, or having a history of AMI in first-degree relatives although some previous studies showed significant associations between the delay time and having DM (12, 13, 15), previous history of CAD, and family history of CAD (10, 18). The discrepancy might be attributed to the small sample size in this study.…”

“…These findings were consistent with studies conducted by Momeni et al in Iran (9) and Peng et al (21) and Qian et al (14) in China who found that the type of transportation vehicle and the location of residency were associated with prehospital delay. However, some studies in Korea (13), Bushehr (10), and Bandar-Abbas (18) have found that residency and type of transportation vehicle were not associated with prehospital delay. Currently the EMS stations are mainly located within cities and then the delay time would be more in suburbs.…”

“…Several factors such as patients’ gender, age, education level, place of residence, their awareness of symptoms, quality, location, type, and time of pain, presence or absence of sweating, history of cardiac disorders, the type of transportation vehicle, and the type of physician the patients had been referred to, influence the prehospital delay time (12-18). …”

Factors associated with pre-hospital delay before reperfusion therapy in patients with ST-segment elevation myocardial infarction

“…[13,22,23] The reason being females could not directly activate the transportation system and they had to first inform their husband or family in most cases and then only process of transportation started. While divergent result was obtained in a study by Banos-Gonzalez et al, [15] Farshidi H. et al, [24] and George L. et al, [25] where no significant association was found between sex and prehospital delay. There were no significant associations with other cardiac risk factors such as diabetes, hypertension, hypercholesterolemia, smoking habits similar to the study from London.…”