Risk factors of delayed pre-hospital treatment seeking in patients with acute coronary syndrome: A prospective study

Abstract

ObjectivesDespite enormous efforts in public education, treatment seeking time still remains more than optimal in patients with acute coronary syndrome. This prospective study tries to determine the risk factors of pre-hospital delay in patients with acute coronary syndrome.MethodsDescriptive data of 190 patients with diagnosis of acute coronary syndrome attending in 2 tertiary level teaching hospital emergency departments were analyzed to determine risk factors of delayed pre-hospital treatment seeking. Demographic, social and clinical characteristics of patients were obtained and they were asked to fully describe their symptoms and the actions they had done after their symptoms onset.ResultsThirty nine (20.52%) of patients were arrived in emergency department in <1 h of their symptoms onset, 73 (38.43%) were arrived between 1 and 6 h and 78 (41.05%) were arrived in >6 h. Sex, route of transport, scene-to-hospital distance, attributing the symptoms to non-cardiac causes and outpatient physician consultation and cigarette smoking were the risk factors of delayed treatment seeking in our studied patients with acute coronary syndrome. Patients with previous history of ischemic heart disease and Coronary Care Unit admission and patients with underlying diseases like diabetes mellitus, hypertension and hyperlipidemia showed a trend to have more delayed treatment seeking behavior but not with a statistically significant difference. Patients with positive family history of acute coronary syndrome arrived in emergency department earlier than other patients but again with not a statistically significant difference.ConclusionMost patients with acute coronary syndrome arrived in emergency department in >6 h of their symptoms onset. Sex, route of transport, scene-to-hospital distance, attributing the symptoms to non-cardiac origins, outpatient physician consultation and cigarette smoking were risk factors of delayed treatment seeking in studied patients.

Knowledge and Socioeconomic Status as The Factors of Pre-hospital Delay in Patients with Acute Coronary Syndrome

“…Patients with unknown economic status are more likely to postpone coming to ED when ACS attacks occur because they will have anxiety about high medical costs that cannot be reached because of the low economic status (Wechkunanukul K, et al, 2017;Fathi M, et al, 2015;Darawad M.W, et al, 2016) Education level is closely related to knowledge because good knowledge can help to determine how individuals recognize and understand the symptoms experienced. Based on this understanding, it can be explained that ACS patients will have an appropriate response when the onset of symptoms is felt.…”

Early Home Care Errors and the Impact on Delay in Hospital for Patients with Coronary Heart Disease

“…Hal ini sesuai dengan penelitian Verulava, Maglakelidze, & Jorbenadze (2017) yang menunjukkan 67% pasien melaporkan bahwa mengalami periode pertama AMI sehingga hanya 35% yang menghubungkan dengan serangan PJK dan segera ke layanan kesehatan. Fathi et al, (2015) yang menyatakan bahwa lebih banyak informasi atau pengetahuan yang diberikan kepada pasien dan keluarga tentang tanda-gejala AMI serta persiapan rencana saat serangan terjadi dapat mengurangi keterlambatan waktu penanganan pasien IMA sebanyak 11 dari 14 responden terlambat kerumah sakit karena kurangnya informasi dan persiapan rencana.…”

Delayed help-seeking for emergency medical care of patients with acute coronary syndrome/myocardial infarction: review of studies

“…Что же касается такой характеристики как семейное положение, то в различных источниках приводятся неоднозначные данные. Так, в проспективном исследовании Fathi M, et al (2015) было показано, что пациенты, состоящие в браке, откладывают обращение к врачу на более длительный срок, и, напротив, быстрее обращаются за МП пациенты, проживающие одни [35]. Результаты исследования Perkins-Porras L, et al (2009) согласуются с данными Moser D, et al (2006), которые показывают, что брак и присутствие стороннего наблюдателя (друг, коллега) были связаны с более коротким сроком принятия решения для обращения за МП [27,36].…”

“…Результаты исследования Perkins-Porras L, et al (2009) согласуются с данными Moser D, et al (2006), которые показывают, что брак и присутствие стороннего наблюдателя (друг, коллега) были связаны с более коротким сроком принятия решения для обращения за МП [27,36]. Напротив, согласно исследованиям Raczynski JM, et al (1999) и Bolivar J, et al (2013), члены семьи (особенно супруги) увеличивают время задержки до вызова СМП, пытаясь предлагать альтернативные стратегии, в то время как присутствие стороннего наблюдателя имело тенденцию к сокращению времени прибытия в реанимационное отделение [35].…”