Hassan AA. Nassrullah, Haider Sobhy Al Hadad, Ali AK. Abutiheen
Abstract
Time delay in seeking the medical help in patients with acute coronary syndrome worsens the prognosis and increase mortality rate from this condition, this study aims to identify the status and causes of time delay in patients with acute ischemic chest pain in seeking medical help who attend coronary care unit (CCU) in AL-Hussein teaching hospital in Kerbala. A total of 129 patients admitted to the CCU over five months period in 2012 complaining of acute chest pain, their mean age was 56.8 ±11.8 years, and 67.5 % of the patients were male. The mean time between the onset of symptoms and treatment was 13.5 ± 22.7 hours. About 50% of them arrived to the hospital after more than 2 hours of the onset of chest pain. Time delay was more in old people, women, widows, patients with low educational standards, and patients with none ST elevation acute myocardial infarction. Patients who arrive after 2 hours, 59% of them claimed that they were not aware of the seriousness of the condition and 25% of them thought that the pain was transient. In conclusion, nearly half of patients arrived to the hospital after the golden hour, 84% of them were not aware of the seriousness of the condition, this indicates the need to decrease time delay mostly by public health educational program should be intensified to improve the awareness of people to the seriousness of chest pain.
Keywords: Chest pain; Time delay; Acute coronary syndrome; CCU; Kerbala
References
1. Oliver JT, Mirzaie M, Forouzanfar MH, et al. Assessing the Global Burden of Ischemic Heart Disease: Part 1: Methods for a Systematic Review of the Global Epidemiology of Ischemic Heart Disease in 1990 and 2010. Glob Heart 2012;7(4):315-329. [PubMed]
2. Cretin S, Willemain T R. A model of prehospital death from ventricular fibrillation following myocardial infarction. Health Serv Res, Fall 1979;14(3):221-234. [PubMed]
3. Mumford AD, Warr KV, Owen SJ, Fraser AG. Delays by patients in seeking treatment for acute chest pain: implications for achieving earlier thrombolysis. Postgrad Med J 1999;75:880 90-94. [PubMed]
4. Zahn R, Schiele R, Gitt AK, et al. Impact of prehospital delay on mortality in patients with acute myocardial infarction treated with primary angioplasty and intravenous thrombolysis. Amer Heart J 2001;142(1):105-11. [PubMed]
5. Motalebi S A, Amirzadeh I, Jamileh. Patients delay in seeking medical care for acute myocardial infarction symptoms. Rawal Medical Journal 2013;38(2). [PubMed]
6. Reducing time-lag between onsets of chest pain that could be due to a heart attack and seeking professional medical help. A report of an evidence review carried out by the Centre for Health and Social Care Research, Sheffield Hallam University on behalf of SY CLAHRC and NHS Rotherham. Allmark, Tod, Macintosh, Gee. Feb-June 2011.
7. Cornelia G, Linda W, Eva B. The Causes of Prehospital Delay in Myocardial Infarction. Dtsch Arztebl Int 2008;105(15):286–291. [PubMed]
8. Perkins-Porras L, Whitehead DL, Strike PC, Steptoe A. Pre-hospital delay in patients with acute coronary syndrome: factors associated with patient decision time and home-to-hospital delay. European Journal of Cardiovascular Nursing 2009;8(1):26-33. [PubMed]
9. Pitsavos C, Kourlaba G, Panagiotakos DB, Stefanadis C. Factors associated with delay in seeking health care for hospitalized patients with acute coronary syndromes: the GREECS study. Hellenic Journal of Cardiology 2006;47(6):329-336. [PubMed]
10. Finn JC, Bett JHN, Shilton TR, Cunningham C, Thompson PL. Patient delay in responding to symptoms of possible heart attack: can we reduce time to care? Med J 2007;187(5):293-298. [PubMed]
11. Alishahi Tabriz A, Sohrabi MR, Kiapour N, Yazdani S. Factors Associated with Delay in Thrombolytic Therapy in Patient with ST-Elevation Myocardial Infarction. J TehUniv Heart Ctr 2012;7(2):65-71. [PubMed]
12. Ghali JK, Cooper RS, Kowatly I, LiaoY. Delay between onset of chest pain and arrival to the coronary care unit among minority and disadvantaged patients. J National Med Associatin 1993;85(3). [PubMed]
13. Deborah B. Diercks DB. Kirk JD, et al. Door-to-ECG time in patients with chest pain presenting to the ED. American Journal of Emergency Medicine 2006; 24:1–7. [PubMed]
14. Goldberg RJ, Spencer FA, Fox KA, et al. Prehospital Delay in Patients With Acute Coronary Syndromes (from the Global Registry of Acute Coronary Events [GRACE]. Am J Cardiol 2009;103(5):598-605. [PubMed]
15. Bradley EH, Curry LA, Webster TR, et al. Keys to Improving Pre-hospital Diagnosis and Management. AMI Circulation 2006;113:1079-1085. [PubMed]
16. Taylor DM, Garewal D, Carter M, Bailey M, Aggarwal A. Factors that impact upon the time to hospital presentation following the onset of chest pain. Emerg Med Australas 2005; 17(3):204-11. [PubMed]
17. McGinn AP, Rosamond WD, Goff DC, Taylor HA, Miles JS, Chambless L. Trends in prehospital delay time and use of emergency medical services for acute myocardial infarction: experience in 4 US communities from 1987-2000. Am Heart J 2005;150:392–400. [PubMed]
18. Annmarie R, Julie C, Michael C. Patients’ action during their cardiac event: qualitative study exploring differences and modifiable factors. BMJ 1998;316(7137):1060–1065. [PubMed]
19. Isaksson RM. Symptoms, prehospital delay and long-term survival in men vs. women with myocardial infarction. A combined register and qualitative study. A thesis presented to Department of Nursing and the Department of Public Health and Clinical Medicine, Umeå University 2011.
20. Robert J G, Frederick A Sr, Keith A A F, David Br. Prehospital delay in patients with acute coronary syndrome. Am J Cardiol 2009;103(5):598-603. [PubMed]
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