A study to explore the factors related to treatment seeking delay among adults diagnosed with acute myocardial infarction at KMCH, Coimbatore

Venkatesan, Vathsala; Madhavi, S; Kumar, Raghavannair Suresh; Kuzhanthaivel, P

doi:10.1016/j.ihj.2018.01.007

Cited by 15 publications

(17 citation statements)

References 5 publications

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“…Previous studies found that patients who reported an increased pain intensity were less likely to arrive late to a hospital. 31,34,36 Similarly, the current study found that patients who had higher pain scale scores were less likely to arrive late to the hospital. This might be due to that patients with severe pain perceived their condition more serious.…”

Section: Variablesupporting

confidence: 67%

Pre-hospital delay among patients with acute myocardial infarction in Saudi Arabia

ALAhmadi¹,

ALSaedi²,

Alahmadi³

et al. 2020

SMJ

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Objectives: To estimate the pre-hospital delay time among patients diagnosed with acute myocardial infarction and to determine factors associated with prehospital delay. Methods: A cross-sectional study was conducted among 200 patients with myocardial infarction at Madinah Cardiac Center, Al Madinah Al Munawarah, Saudi Arabia between November 2019 and March 2020. Data were collected by direct physician-subject interviews. We used the validated version of the modified response to symptoms questionnaire. Chi-square test, t test, Original Article and multivariate analysis were used to examine factors associated with pre-hospital delay. Results: The median pre-hospital delay time was 3.7 hours. Among all the patients, 126 patients (63%) arrived at the hospital later than 2 hours from the onset of symptoms. Factors that were significantly associated with pre-hospital delay included a previous information on acute coronary syndrome (adjusted odds ratio [adj OR]=0.35, 95% confidence interval [CI] 0.1-0.6), history of hypercholesteremia (adj OR=2.3, 95% CI 1.1-4.7), arrived by ambulance (adj OR=0.3, 95% CI 0.1-0.8), and increased pain intensity (adj OR=0.7, 95% CI 0.6-0.9). Conclusion: Approximately two-thirds of the patients arrived later than 2 hours from the onset of symptoms. A previous information about acute coronary syndrome, history of hypercholesteremia, arrived by ambulance, and increased pain intensity were associated with pre-hospital delay. The study recognizes the need for educational programs about acute myocardial infarction symptoms and the benefits of availing an ambulance service.

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Section: Variablesupporting

confidence: 67%

Pre-hospital delay among patients with acute myocardial infarction in Saudi Arabia

ALAhmadi¹,

ALSaedi²,

Alahmadi³

et al. 2020

SMJ

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“…In agreement with our findings, atypical symptoms, such as fatigue and non-chest pain, were reported as significant predictors for pre-hospital delays ( 9 , 11 ). Atypical symptoms were frequently perceived as benign and non-cardiac in origin ( 24 ), hence the lack of urgency to seek treatment earlier in a hospital. Our society may be aware of typical angina symptoms, such as crushing retrosternal chest pain with classical Levine’s sign, but many still lack awareness regarding atypical presentations that may occur, especially among females and among diabetic patients with neuropathy.…”

Section: Discussionmentioning

confidence: 99%

“…Decision making time significantly depends on patients’ cognitive factors and their intuitive understanding about myocardial infarction. Inadequate knowledge may lead to the patients’ misinterpreting their own symptoms, subsequently furthering delay in decision making for seeking proper treatment ( 24 ). Our study found that patients who perceived their symptoms as cardiac in origin had significantly shorter symptom-to-door times ( P = 0.005).…”

Section: Discussionmentioning

confidence: 99%

Pre-Hospital Factors Influencing Time of Arrival at Emergency Departments for Patients with Acute ST-Elevation Myocardial Infarction

Lim

Rahman

Yaacob

2019

MJMS

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BackgroundPre-hospital delay is currently a major factor limiting early reperfusion among ST-elevation myocardial infarction (STEMI) patients worldwide. This study aims to determine pre-hospital factors affecting symptom-to-door time among STEMI patients in Malaysia.MethodsThis cross-sectional study included 222 STEMI patients admitted to two tertiary hospitals in Malaysia. By determining symptom-to-door time, the study population was categorised into two definitive treatment seeking groups: early (≤ 3 h) and delayed (> 3 h). Data was collected focusing on socio-demographical data, risk factors and comorbidities, clinical presentation, situational factors and action taken by patients.ResultsThe mean age of our patients was 58.0 (SD = 11.9) years old, and the population consisted of 186 (83.8%) males and 36 (16.2%) females. Our study found that the median symptom-to-door time was 130.5 (IQR 240) min, with 64% of subjects arriving early and 36% arriving late. Pre-hospital delays were found to be significant among females (adj OR = 2.42; 95% CI: 1.02, 5.76; P = 0.046), patients with recurrence of similar clinical presentations (adj OR = 2.74; 95% CI: 1.37, 5.46; P = 0.004), patients experiencing atypical symptoms (adj OR = 2.64; 95% CI: 1.11, 6.31; P = 0.029) and patients who chose to have their first medical contact (FMC) for their symptoms with a general practitioner (adj OR = 2.80; 95% CI: 1.20, 6.56; P = 0.018). However, patients with hyperlipidaemia (adj OR = 0.46; 95% CI: 0.23, 0.93; P = 0.030), self-perceived cardiac symptoms (adj OR = 0.36; 95% CI: 0.17, 0.73; P = 0.005) and symptoms that began in public places (adj OR = 0.21; 95% CI: 0.06, 0.69; P = 0.010) tended to seek treatment earlier.ConclusionThe symptom-to-door time among the Malaysian population is shorter in comparison to other developing countries. Nevertheless, identified, modifiable pre-hospital factors can be addressed to further shorten symptom-to-door time among STEMI patients.

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“…This has been reported in other studies also where misinterpretation of symptoms was found to be a major factor responsible for pre hospital delays. [7][8][9][10][11][12] The other reason for delay in presentation could be the fact that many of our patients comes from hilly areas where traffic movement is slower. This was seen more so among females, where only 2 out of 20 females (10%) received treatment in first 2 hours compared to 15 of 80 (18.8%) men.…”

Section: Discussionmentioning

confidence: 99%

“…depending upon the social, cultural and local beliefs particularly in India where there is wide variation in these practices. [5][6][7][8][9][10][11][12] Our hospital caters to a quiet varied population coming from hilly and far flung rural areas where the educational, socioeconomic and health awareness level of people is quiet variable and transportation is sometimes a big issue. Therefore, this study was planned to assess the factors leading to delays in presentation and treatment and to evaluate its impact on the short term outcome.…”

mentioning

confidence: 99%

Assessment of pre-hospital and in-hospital factors leading to delays in initiation of treatment in patient with ST segment elevation myocardial infarction

Kashyap

Sood

Kashyap

2020

Int J Community Med Public Health

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Background: India has the highest burden of acute coronary syndrome (ACS) patients in the world. While managing patients with ACS, especially those with acute ST elevation myocardial infarction (STEMI), time plays an important role in determining the morbidity and mortality.Methods: An observational prospective study was conducted among patients admitted with symptomatic STEMI. Questionnaire based information was obtained regarding demographic profile, risk factors, treatment seeking behaviour including duration and reasons for delay and treatment in the hospital. Outcome was assessed at discharge and at 30 days.Results: A total of 100 patients were given a definite diagnosis of STEMI. The mean age was 55.38 (SD 10.28) years. Majority 80 (80%) were males and females constituted 20%. Sedentary lifestyle was the major risk factor present in sixty (60%) patients. The median time from symptoms to hospital was 420 min (range 30-2880 minutes). Only 17% patients reached hospital within 2 hours of symptoms and 37% between 2 to 6 hours and 46% after 6 hours. Thirty five patients (35%) thought it to be a heart attack. Hospital delay was recorded in 50% patients with ECG done in more than 10 minutes. Outcome at 30 day depicted as mortality in three patients with loss to follow in 18 (18%) and angina in 6 out of 81 (7.4%) patients.Conclusions: Both pre hospital and in hospital delays have adverse effect on the outcome and thus efforts should be made to minimize these delays.

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A study to explore the factors related to treatment seeking delay among adults diagnosed with acute myocardial infarction at KMCH, Coimbatore

Cited by 15 publications

References 5 publications

Pre-hospital delay among patients with acute myocardial infarction in Saudi Arabia

Pre-hospital delay among patients with acute myocardial infarction in Saudi Arabia

Pre-Hospital Factors Influencing Time of Arrival at Emergency Departments for Patients with Acute ST-Elevation Myocardial Infarction

Assessment of pre-hospital and in-hospital factors leading to delays in initiation of treatment in patient with ST segment elevation myocardial infarction

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