Related Experiment Video
Updated: May 7, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Decoding the "Pain-to-Door" interval using psychological, medical, and demographic factors: A multi-center study
Hamidreza Roohafza1, Feridoun Noohi2, Sara Bagherieh3
1Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Reducing myocardial infarction pain-to-door time is crucial. Male patients and those with angina history had shorter intervals, while health anxiety, depression history, high socioeconomic status, and sense of coherence were linked to longer delays.
Area of Science:
- Cardiology
- Psychology
- Public Health
Background:
- The "pain-to-door" interval in myocardial infarction (MI) is critical for patient outcomes.
- Identifying factors influencing this interval is essential for timely healthcare access.
Purpose of the Study:
- To investigate psychological, medical, and demographic factors associated with the pain-to-door interval in MI patients.
- To understand how these factors influence the time from symptom onset to hospital arrival.
Main Methods:
- Analysis of baseline data from 1685 participants in a 3-year, multi-centric cohort study.
- Utilized validated questionnaires to assess sociodemographic factors, depression, health anxiety, personality, sense of coherence, coping, and quality of life.
- Statistical analysis included p-value and hazard ratio calculations.
Main Results:
- Male sex (HR: 0.81) and history of angina (HR: 0.82) were associated with shorter pain-to-door times.
- Health anxiety (HR: 1.27), history of depression (HR: 1.57), high socioeconomic status (HR: 1.25), and sense of coherence (HR: 1.34) were linked to longer pain-to-door times.
- History of diabetes mellitus showed a marginal association (p=0.059) with shorter intervals.
Conclusions:
- Personal, social, and economic characteristics significantly influence the pain-to-door interval in MI.
- Screening high-risk individuals and educating the public and healthcare providers on this interval's importance is a priority.
- Addressing these factors can help mitigate the impact of cardiovascular diseases (CVDs).
Background:
Reducing the amount of time between the onset of symptoms and presentation to a healthcare facility, namely the "pain-to-door" interval, is of utmost importance in patients with myocardial infarction. In the present study, we aimed to shed light on the psychological, medical, and demographic factors that are associated with this vital time, and the details of this association.
Methods:
We used the baseline data of 1685 participants from a 3-year, multi-centric, cohort study. The pain to door time was estimated as the interval between symptoms' onset and arrival at the hospital. Patients were asked to fill out valid and reliable questionnaires regarding sociodemographic factors, depression, health anxiety, type D personality, sense of coherence, coping strategies, and quality of life. Data was then analyzed to attain the p-value and hazard ratios (HR) of different variables.
Results:
In the multivariate analysis, being male (HR: 0.81, 95% CI: 0.68-0.98) and a history of angina (0.82, 0.69-0.96) were associated with shorter pain-to-door durations. A history of diabetes mellitus also made the cut marginally (p-value: 0.059). On the contrary, health anxiety (1.27, 1.09-1.49), history of depression (1.57, 1.21-2.05), high socioeconomic status (1.25, 1.03-1.51) and sense of coherence (1.34, 1.14-1.57) scores were associated with longer pain-to-door durations.
Conclusion:
Our findings demonstrate that personal, social, and economical characteristics play a pivotal role in determining patients' pain-to-door time duration. Screening high-risk individuals in terms of the factors that tend to increase the pain-to-door time alongside educating people and healthcare providers on the importance of this interval and its contributing factors must be a priority considering the devastating burden of CVDs.
Related Concept Videos
01:20Pain
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation