title: [Delays in the management of AMI: Results of an investigation conducted in Sousse (Tunisia)].
abstract: The goal of our work was to assess the delays of admission for Acute Myocardial Infarction (AMI) in Sousse (Tunisia) and to identify predictors of these delays. Our prospective survey was led from January 1999 to December 2001; 232 patients with AMI were included. The onset of symptoms usually occurred in the patient's home (80.6%). The chest pain was atypical in 19.4% of cases; 91% of patients directly consulted the emergency departments, whereas the ambulatory emergency services were used in only in 2.2% of cases. Delays of hospitalization in coronary care units were on average too long (14 h 21 min +/- 19 h 16 min). This prolongation was essentially caused by a too long period between onset of symptoms and first patient call. In bivariate analysis, dyslipidemia, diabetes, absence of smoking and an atypical symptoms were associated with prolonged hospitalization delays. However in multivariate analysis, only diabetes and atypical symptoms were independent factors associated with a hospitalization delay of more than 12 h. In 23% of the patients, a prolonged pre-hospital time period prevented the use of thrombolysis.
  
  
  CONCLUSIONS
  Pre-hospital delays should be shortened by a multidisciplinary action that especially focuses on a better sanitary education of patients to risk.
authors.affiliation: Service de cardiologie, centre hospitalier universitaire (CHU) Farhat-Hached, 4000 Sousse, Tunisie. Abdallah.mahdhaoui@famso.rnu.tn
authors.forename: A
authors.initials: A
authors.lastname: Mahdhaoui
authors.forename: H
authors.initials: H
authors.lastname: Bouraoui
authors.forename: M A
authors.initials: MA
authors.lastname: Majdoub
authors.forename: A
authors.initials: A
authors.lastname: Ben Abdelaziz
authors.forename: B
authors.initials: B
authors.lastname: Trimeche
authors.forename: J
authors.initials: J
authors.lastname: Zaaraoui
authors.forename: G
authors.initials: G
authors.lastname: Jeridi
authors.forename: S Ernez
authors.initials: SE
authors.lastname: Hajri
authors.forename: H
authors.initials: H
authors.lastname: Ammar
mesh_terms: D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002637:Chest Pain / Q000150:complications; D003325:Coronary Care Units / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D016017:Odds Ratio; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014187:Transportation of Patients / Q000379:methods / Q000706:statistics & numerical data; D014416:Tunisia
vernacular_title: Délais de prise en charge de l'IDM en phase aiguë: résultats d'une enquête dans la région de Sousse (Tunisie).