Frequency and determinants of timely arrival among patients of acute myocardial infarction at a public sector tertiary care hospital in Karachi

摘要

Objective: To determine the time from onset of symptoms to start of fibrinolysis and treatment in acuteST elevated myocardial infarction patients and identify the factors which cause delay in treatment.Methods: A cross sectional study was conducted at National Institute of Cardiovascular Diseases, Karachion 360 conveniently selected patients of ST elevated myocardial infarction from July to September inthe year 2017. Structured questionnaire was used to obtain detailed information on socio-demographics,factors which cause delay and timing of onset of symptoms to arrival of patient in emergency ward.Results: Overall, the total average time from the start of symptoms to initiation of treatment was119.85±63.32 minutes. Only 5.1% patient reached within one hour while 57.7% reached within two hours.Old age group of 60 and above was positively associated with timely arrival (OR=2.75, 95% CI 1.33-5.68,p=0.006). Significant positive association of using personal car as mode of transport to reach the hospital(OR=5.25, 95% CI 2.94-9.35, p0.001) was also found as compared to using ambulance. Distance fromfacility was suggestive of negative association in the model but was statistically insignificant.Conclusion: According to the findings of this study, more than one third of patients reached the hospitalwithin two hours of initiation of symptoms while only 5.1% reached within one hour. The delay was mostlypre-hospital attributed to arranging transport, stay at first medical contact and time taken from firstmedical contact to the hospital.