ABSTRACT
Objective: To determine the factors that affect time to hospital presentation in persons with symptoms suggestive of an acute myocardial infarction.
Methods: A cross-sectional study was done at the emergency department at the University Hospital of the West Indies, Kingston Jamaica. One hundred and fifty persons whopresented with symptoms suggestive of an AMI and were later diagnosed as such were analyzed.
Results: Among the 150 patients, 52 % of patients presented to the hospital 12 hours or later and 48 % of patients presented earlier than 12 hours. A significant predictor of earlier presentation (odds ratio, % CI) was fear of possible diagnosis (0.50, 0.25 – 0.99). Although not statistically significant, another factor associated with early presentation was persons with medical insurance (0.41, 0.19 – 0.87). None of the factors associated with delayed presentation 12 hours or later were found to be statistically significant, but were still deemed to be clinical important. These included elderly patients (1.03, 1.01 – 1.06), patients with prior stroke (1.88, 0.76 – 4.66) and patients with heart failure (1.82, 0.76 – 4.37).
Conclusion: Patients who have a myocardial infarction oftendelay in presenting to the hospital. This is a problem that many hospitals face globally and several factors have been found to be common among them. Educational programs targeting the study population and new strategies for easier access to health care facilities may be implemented so as to decrease prehospital times.
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