Delayed presentation for care during acute myocardial infarction in a Hispanic population of Los Angeles County.
BACKGROUND
Delay in seeking care for acute myocardial infarction (AMI) has been well described in some populations, but little research has been conducted on delay by minority groups, such as Latinos and Asians. This study sought to determine the degree of delay and mode of access of patients with AMI presenting to an inner-city hospital serving an ethnically diverse population.


RESULTS
This study was a retrospective case series of Latino, Asian, African-American and Caucasian patients diagnosed in the emergency department (ED) with chest pain (CP) and AMI, during a 2-year period. Three hundred thirty seven cases were studied, with the average delay in presentation for care being 44.3 hours, with a median of 8.8 hours. Before seeking care for symptoms of AMI, Latinos delayed an average of 41.5 hours (median 9.2 hours); African Americans delayed an average of 30.8 hours (median 3.5 hours); Asians delayed an average of 92 hours (median 12 hours); and Caucasians delayed an average of 31.6 hours (median 3.2 hours). The mode of transportation used by the different groups to travel to the ED was also significantly different, with Latinos and Asians utilizing private transportation the majority of the time (70% and 83%, respectively).


CONCLUSIONS
There is a significant delay in presentation for care in patients experiencing AMI in Los Angeles County, greatest among the Asian and Latino populations. Once the decision to seek assistance is made, an under-utilization of EMS compounds the problem. Socioeconomic status, language, and cultural practices pose unique barriers to recognizing and addressing symptoms of AMI in this population.
Henderson
Sean O
SO
Department of Emergency Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, USA. sohender@hsc.usc.edu
Magana
Renee N
RN
Korn
Carrie S
CS
Genna
Tammy
T
Bretsky
Philip M
PM
D001741:Black or African American / Q000523:psychology; D000368:Aged; D000704:Analysis of Variance; D001213:Asian / Q000523:psychology; D016001:Confidence Intervals; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000208:ethnology* / Q000628:therapy*; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011203:Poverty; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D044465:White People / Q000523:psychology