Time lag to hospitalisation and the associated determinants in patients with acute myocardial infarction: the Takashima AMI Registry, Japan

Abstract

About one-fifth of patients with AMI have prolonged time lag in the study population. Future research intervention and health promotion activities should focus on achieving a reduction in presentation delays.

Factors Associated With Prehospital Delay Among Patients With Acute Myocardial Infarction in the Era of Percutaneous Coronary Intervention ― Insights From the OACIS Registry ―

“…Logistic regression analyses were used to examine factors associated with prehospital time ≥2 h. Potential confounding factors before hospital arrival based on previous studies were included in the univariable and multivariable analyses. 12,14, 15 These variables were as follows: age (<65 years, 65-79 years, ≥80 years); sex (male, female); existence of living together (alone, not); employment status (unemployed, not); history of ACS (yes, no); DM (yes, no); hypertension (yes, no); dyslipidemia (yes, no); smoking and drinking habits (yes, no); ambulance use (yes, no); onset time (daytime, nighttime); day of the week (weekday, weekend); season (spring, summer, autumn, winter); and year (1998-2003, 2004-2008, 2009-2014). In a sensitivity analysis, we also examined prehospital time of ≥4 h and ≥6 h based on a previous study.…”

“…In a sensitivity analysis, we also examined prehospital time of ≥4 h and ≥6 h based on a previous study. 14,15 Results were presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). In addition, differences in prehospital time were assessed for each prehospital factor.…”

Deciding to Seek Emergency Care for Acute Myocardial Infarction

“…Moreover, patients were found to delay longer when their symptoms developed slowly or were intermittent, did not match their expectation of an AMI, or were attributed to non-cardiac causes (Caldwell & Dracup, 2008;Turin et al, 2011).…”

“…Several factors associated with prolonged delay in seeking care during an AMI were identified in quantitative studies, such as female gender, old age, and comorbidity. Moreover, patients were found to delay longer when their symptoms developed slowly or were intermittent, did not match their expectation of an AMI, or were attributed to non-cardiac causes (Caldwell & Dracup, 2008; Khraim & Carey, 2009; Turin et al, 2011).…”

“…The time from symptom onset till arrival to the hospital is called delay time and most of it is accounted for by how long it takes the patient to decide to seek emergency care. Western countries reported median delay times near 2 hr (Dracup et al, 2009; Turin et al, 2011) versus 3.5 to 5 hr in Asia (Abba et al, 2003; Khraim, Scherer, Dorn, & Carey, 2009; Yu et al, 2006), including 4.5 hr in Lebanon (Noureddine et al, 2006).…”