Factors affecting time to arrival in hospital among patients with acute myocardial infarction (MI)

Abstract

Time is crucial in the treatment of acute myocardial infarction but patients still come late to the hospital. This study aims to determine the factors which delay such patients coming to the ICCU. 100 patients (74 men & 26 women) of acute MI were interviewed. The mean time from symptom onset to ICCU arrival was 28 hrs. 55 min. (+ 96hrs 45min). 51 patients came within 6 hours – 13, 20 and 18 within 1,3 and 6 hours. Using the dependent variable of time as a binomial variable, univariate analysis showed that a perception that the chest pain could be cardiac in origin was more common among the early arrivers (<6 hrs) while, visiting a doctor in the clinic instead of going to an ICU directly, was more common among the late arrivers. Logistic regression analysis showed these two as significant factors with a weak to moderate relation (coefficient of determination r 2 = 0.22 only). Analyzing the data using time as a continuous variable, which is the more appropriate statistical method, the statistical significance of the above two factors reduced to a trend, while another factor emerged – presence of a (para)medical person in the family hastened arrival to the ICCU. Multiple regression analysis did not reveal a statistically significant correlation (r2 = 0.089). Gender, age, literacy, mode of transport and past history of MI were not significant factors. To conclude, patients with acute MI still arrive late to the ICCU with two important reasons being the decision making of the patient based on a perception that the pain could be cardiac, and, going to an ICCU directly rather than to a doctor‟s clinic or hospital without such facility.