CARDIOVASCULAR RESEARCH CENTER, NEMAZI HOSPITAL, SCHOOL OF MEDICINE, SHIRAZ, UNIVERSITY OF MEDICAL SCIENCES, SHIRAZ, IRAN
Objective: The aim of this study was to evaluate delay factors leading to late arrival at hospital after the onset of a chest pain and delays to start thrombolytic therapy in Shiraz University Hospitals, which may increase mortality and morbidity rates after myocardial infarction and compare these times with those in other countries.
Methods: Time delays in 212 patients diagnosed as. acute coronary syndrome were investigated as the delay between the onset of the symptom and seeking help (period one: patient's time); the time between seeking help and transfer to hospital (period 2: transport time); and the period between the first medical diagnosis and the start of thrombolytic therapy or other interventions or transferring factors to the coronary care unit (period 3: arrival at hospital).
Results: The mean time in period one was 47.12 minutes, which was dependent upon the denial on the part of the patient and his/her family and the start of self-medication by the patients who wished to wait and see if the symptoms would disappear. The mean time in period 2 was 46.36 minutes, which was dependent upon whether the ambulance, public or personal transportation was used by the patients and also the whereabouts of the patients. The mean time in period 3 was 44.16 minutes, which was dependent upon the availability of health care professionals and well-trained doctors in emergency departments of the university hospitals.
Conclusion: Period one can be reduced by educating patients; period 2 can be scaled down by providing more ambulances and emergency care units in different areas of Shiraz; and period 3 can be lessened by providing better-trained doctors and starting thrombolytic therapy in the emergency department.