Predictors of Pre-hospital Delay in Myocardial Infarction: A Cross-sectional Study at a Tertiary Care Center of Ahmedabad, India.

Abstract

Background: Myocardial infarction (MI) is a leading cause of death globally, with early treatment being critical in reducing mortality. Understanding determinants contributing to pre-hospital delay is essential to improve the outcome.

Objective: The present study evaluated the time distribution between symptom onsets to hospital arrival and associated factors among patients with MI.

Materials and methods: A cross-sectional study included 105 MI patients admitted to a tertiary care teaching hospital in Ahmedabad city during March to August 2024. Patients fulfilling the inclusion criteria were interviewed using a pre-tested, semi-structured questionnaire. Pre-hospital delay was considered as the time elapsed from symptom onset to arrival at a tertiary care hospital among MI patients. Delay was categorized into two groups: ≤2 hours and >2 hours. Appropriate statistical tests were used to assess the association between factors influencing the time from symptom onset to hospital arrival.

Results: The median time from symptom onset to tertiary hospital arrival was 90 minutes (Interquartile range: 45-210 minutes). Out of a total of 105 participants, 37 (35.2%) experienced delays of >2 hours. Younger age (odds ratio [OR]: 2.16; P = 0.171), female gender (OR: 3.2; P = 0.03), and nuclear family structure (OR: 1.56; P = 0.39) were predictors of pre-hospital delay. Patients having previous similar episodes of symptoms or who misinterpreted them as non-heart-related also reported longer delays.

Conclusion: Approximately one-third of patients reported a delay of >2 hours. Younger age, female gender, nuclear family structure, previous episodes of symptoms, and misinterpretation of symptoms were significant determinants of pre-hospital delay in MI patients.