Delays in Presentation by Patients with ST Elevation Myocardial Infarction: A single centre experience from Oman
Suhaib Almashari1, Yasir Al-Malki1, Adil Al-Riyami2
1Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman.
Insights
Many ST-elevation myocardial infarction (STEMI) patients arrived promptly, but public education is needed. Patients often delayed seeking care, underestimating chest pain importance or its cardiac origin.
Area of Science:
- Cardiology
- Emergency Medicine
- Public Health
Background:
- ST-elevation myocardial infarction (STEMI) is a critical cardiac emergency requiring rapid intervention.
- Timely presentation to the emergency department is crucial for effective treatment of STEMI.
- Understanding patient delay factors is key to improving outcomes.
Purpose of the Study:
- To investigate the reasons for delayed patient presentation with STEMI.
- To identify factors contributing to delayed treatment-seeking behavior in STEMI patients.
Main Methods:
- Retrospective analysis of 101 STEMI patients admitted for primary angioplasty.
- Data collected from January 2017 to December 2019 at Sultan Qaboos University Hospital, Muscat, Oman.
- Analysis of patient demographics, pain-to-door times, transport methods, and self-reported reasons for delay.
Main Results:
- The median pain-to-door time was 60 minutes (IQR 30-120 min).
- 65.4% of patients arrived within 90 minutes; most used private transport.
- Primary reasons for delay included underestimating pain importance (61.0%) or not recognizing it as cardiac (22.8%).
- Diabetes was the only patient factor predicting delay.
Conclusions:
- A significant proportion of STEMI patients reached the hospital within recommended times.
- Public education is essential to raise awareness about the urgency of chest pain evaluation.
- Addressing patient-related delays, such as underestimation of symptoms, is vital for improving STEMI care.
Objectives:
To assess the causes of delay for presentation with ST elevation myocardial infarction (STEMI).
Methods:
Patients who presented with STEMI to the Emergency Department at the Sultan Qaboos University Hospital, Muscat, Oman between January 2017 and December 2019 and were admitted for primary angioplasty were included in this study.
Results:
A total of 101 patients were included with a mean age of 54.8 + 10.8 years and the majority were male patients (n = 80; 79.2%). The median (interquartile range) pain-to-door time was 60 min (30-120 min). There were 66 (65.4%) patients who arrived within 90 minutes. All except one arrived by privately arranged transport. Feeling that the pain was not important (61.0%) or not cardiac (22.8%) were the main reasons for delay. Being diabetic was the only patient factor that predicted delay.
Conclusion:
A high proportion of patients presenting to our institution with a STEMI arrived within recommended times. However more public education is required to improve awareness about the importance of early evaluation of chest pain.
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