Factors associated with prolonged prehospital delay of African Americans with acute myocardial infarction
Angela D Banks1, Kathleen Dracup
1School of Nursing, University of San Francisco, San Francisco, CA, USA.
Insights
African Americans experience prolonged delays in seeking treatment for acute myocardial infarction (AMI). Factors like insurance status and marital status, not perceived racism, were linked to these delays, highlighting a need for patient and family education.
Area of Science:
- Cardiology
- Public Health
- Health Disparities
Background:
- African Americans experience longer delays in seeking treatment for acute myocardial infarction (AMI) compared to white individuals.
- Prehospital delay in AMI treatment can lead to reduced therapeutic benefit and poorer outcomes.
Purpose of the Study:
- To identify factors contributing to prolonged prehospital delay in African Americans with AMI.
- To investigate the role of perceived racism in prehospital delay among African Americans experiencing AMI.
Main Methods:
- A cohort of 61 African Americans with AMI were interviewed within one month of hospital admission.
- Delay times were calculated, and statistical analyses (independent t tests, chi-squared tests) were used to identify factors associated with prolonged delays.
Main Results:
- The median delay for seeking AMI treatment was 4.25 hours, significantly longer than the recommended <1 hour.
- Factors associated with longer delays included being insured, single/widowed/divorced status, and having diabetes.
- Perceived racism did not significantly influence prehospital delay in this cohort.
Conclusions:
- Substantial delays in seeking AMI treatment among African Americans necessitate urgent interventions.
- Patient and family education and counseling are crucial strategies to reduce prehospital delay and improve outcomes.
Background:
Delays in seeking treatment for signs and symptoms of acute myocardial infarction are longer for African Americans than for whites.
Objective:
To determine factors associated with prolonged delay and the extent to which perceived racism influences prehospital delay in African Americans with acute myocardial infarction.
Methods:
Sixty-one African Americans with acute myocardial infarction were interviewed within 1 month of hospital admission. Delay times were calculated on the basis of the interviews. Independent t tests and chi(2) tests were used to determine factors associated with prolonged delays.
Results:
Median delay was 4.25 hours and did not differ significantly between women and men (4.42 vs 3.50 hours). Most patients (69%) experienced their initial signs and symptoms at home, often witnessed by family members or friends (70%). Delay was longer for insured patients than for uninsured patients (4.45 vs 0.50 hours). Single, widowed, or divorced patients had longer delay times than did married patients (5.33 vs 2.50 hours), and patients with diabetes delayed longer than did those without diabetes (7.29 vs 3.50 hours). Perceived racism did not differ significantly between patients who delayed seeking treatment and those who did not.
Conclusions:
Median delay times were substantially longer than the recommended time of less than 1 hour, reducing the benefit from reperfusion therapies. Education and counseling of patients and their families should be a major strategy in optimizing patients' outcomes and decreasing the time to definitive treatment.
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