Factors influencing pre-hospital delay among patients with acute myocardial infarction in Iran

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Maryam Momeni(Nursing Education, Qazvin University of Medical Sciences,Qazvin Nursing and Midwifery College, Qazvin, Iran)
Arsalan Salari(Department of Cardiology , Cardiovascular Disease Research Center, Guilan University of Medical Sciences, Heshmat Hospital, Rasht, Iran)
Shora Shafighnia(General Practitioner , Cardiovascular Disease Research Center, Guilan University of Medical Sciences, Heshmat Hospital, Rasht, Iran)
Atefeh Ghanbari(Nursing Education, Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran)
Fardin Mirbolouk(Department of Cardiology , Cardiovascular Disease Research Center, Guilan University of Medical Sciences, Heshmat Hospital, Rasht, Iran)
Journal Title:
Chinese Medical Journal
Volume 125, Issue 19, 2012
Key Word:
pre-hospital; delay; acute myocardial infarction; cardiovascular disease

Abstract: Background Acute myocardial infarction (AMI) is the leading cause of morbidity and disability among Iranian population.Pre-hospital delay is an important cause of increasing early and also late mortality in AMI.Thus the aim of the present study was to identify the factors influencing pre-hospital delay among patients with AMI in Iran.Methods Between August 2010 and May 2011,a cross-sectional and single-center survey was conducted on 162 consecutive patients with ST-elevation myocardial infarction (STEMI) admitted to Cardiac Care Unit (CCU) of Dr.Heshmat Hospital,Rasht.All patients were interviewed by the third author within 7 days after admission by using a four-part questionnaire including socio-demographic,clinical,situational and cognitive factors.Data were analyzed by descriptive and Logistic regression model at P < 0.05 using SPSS 16.Results Mean age was (60.11±12.29) years in all patients.Majority of patients (65.4%) were male.The median of pre-hospital delay was 2 hours,with a mean delay of 7.4 hours (±16.25 hours).Regression analysis showed that admission in weekend (P <0.04,OR=1.033,95% Cl=1.187-2.006) and misinterpretation of symptoms as cardiac origin (P <0.002,OR=1.986,95% Cl=1.254-3.155) and perceiving symptoms to not be so serious (P <0.003,OR=3.264,95%Cl=1.492-7.142) were factors influencing pre-hospital delay > 2 hours.Conclusions Our findings highlight the importance of cognitive factors on decision-making process and pre-hospital delays.Health care providers can educate the public on AMI to enable them recognize the signs and symptoms of AMI correctly and realize the benefits of early treatment.

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