Pre-Hospital Delays Still Common for Heart Attack Patients

During the past 20 years, mean and median delay times have essentially remained unchanged

WEDNESDAY, Dec. 24 (HealthDay News) -- In patients with acute myocardial infarction, delay times in seeking medical care have not changed during the past 20 years, according to research published in the Dec. 15 issue of the American Journal of Cardiology.

Jane S. Saczynski, Ph.D., of the University of Massachusetts Medical School in Worcester, and colleagues studied 5,967 Worcester-area patients (mean age 76) who were hospitalized between 1986 and 2005.

The investigators found that mean and median pre-hospital delay times were 4.1 and 2.0 hours in 1986, 4.7 and 2.2 hours in 1995, and 4.6 and 2.0 hours in 2005, respectively. Overall, about 45 percent of patients presented within two hours of symptom onset, the authors note, but about 33 percent did not present until two to six hours after symptom onset and were less likely to receive thrombolytic therapy and percutaneous coronary intervention within 90 minutes of arrival. The researchers also found that prolonged delay was associated with older age and a history of either diabetes or a previous myocardial infarction.

"We did not collect information about the reasons patients delayed seeking medical treatment because of our methods of data collection and primary reliance on medical chart abstraction," the authors write. "In future studies, systematic collection of pre-hospital delay data, including reasons for delay from patients' perspectives, may help in developing more targeted interventions and decreasing the magnitude of missing data. It would also be useful to study the importance of bystanders and the role of acute situational factors, socioeconomic status, medical insurance coverage, and cultural reasons for delays in care seeking in the setting of acute coronary symptoms."

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