Average Delay in Calling Hospital With a Heart Attack: 6.4 Hours
by Dr. Stephen Parker (Article selection and Commentary) on April 9, 2010
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Australian patients’ delay in response to heart attack symptoms
objectives: To examine delay in seeking treatment among patients with an evolving acute myocardial infarction (MI), and to identify factors which contributed to this delay.
Design: Patient interview combined with medical record review.
Participants and setting: 317 patients with confirmed diagnosis of acute MI interviewed within 72 hours of admission to three hospitals.
Main outcome measures: Delay from onset of symptoms to arrival at hospital, and cognitive, emotional, sociodemographic and clinical factors which contributed to increased prehospital delay.
Results: Median prehospital delay was 6.4 hours; 41% of patients delayed less than four hours, while 28% delayed less than two hours. Prehospital delay was increased in patients with fewer years of education (P = 0.001), lower income (P = 0.003) and transportation to the hospital by private car rather than ambulance (P = 0.02). Delay time was increased by several cognitive and emotional processes (P < 0.001), such as waiting to see if symptoms would go away, being too embarrassed to ask for assistance, and not recognising the importance of symptoms. Delay time was increased with heartburn, breathlessness or intermittent symptoms and decreased with sweating and dizziness (P < 0.05). Independent predictors of increased prehospital time (P < 0.01) were fewer than 10 years of education, not wanting to trouble anyone, failing to recognise the symptoms of delay, and the intermittent nature of symptoms.
Conclusion: Over 50% of acute MI patients delay seeking treatment by six hours or more. Many factors related to cognitive and social processes that contribute to this delay may be remediable with appropriate patient and community education.
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Medical Journal of Australia; 2007
Comment
I looked for this research in response to Carolyn Thomas’s comment about the importance of calling 911 immediately, that a home heart attack test might delay this. These are kind of disturbing findings — “time is heart muscle” is a cardiology mantra. 6.4 hours will kill a lot of heart cells. And 50% of folks die from heart attacks before they even get to a hospital.
Even though I had a history of heart disease and heart problems with three stents, I never really understood what the symptoms of a heart attack really were, and wasn’t ready when they heart attack happened. I really think the cardiology profession could do a lot more in terms of educating people. Someone should have gone over and over with me about heart attack symptoms, about calling an ambulance and not driving to the hospital. Even more than that, if I had had a weekly phone call just to talk about how things were going, how the meds were doing, how I was feeling — I think I could have missed the whole heart attack experience. There is a business out there for someone to establish a heart support line that cardiologists could outsource (let’s keep it in the US though). I would bet this would reduce hospital visits, heart attacks, etc. Are you listening, insurance companies? This should be a major part of health reform.
Tagged as:
acute myocardial infarction,
Australia,
Carolyn Thomas,
delay,
heart,
heart attack symptoms,
US
