title: Prehospital delay in patients hospitalized with acute myocardial infarction in the emergency unit of a North Indian tertiary care hospital.
abstract: BACKGROUND
  Prompt treatment of patients presenting with acute myocardial infarction decreases the incidence of death from early arrhythmia, and maximizes the potential benefit of thrombolytic therapy. Prehospital delay has been identified as a major obstacle to the widespread use of thrombolytic therapy. The aim of the present study was to examine the extent of, and factors associated with, delay in seeking medical care (usually thrombolytic therapy) in patients with acute myocardial infarction.
  
  
  RESULTS
  The study was conducted in patients visiting the medical emergency unit of the Nehru Hospital, Post Graduate Institute of Medical Education and Research, Chandigarh. A total of 104 patients diagnosed with acute myocardial infarction were interviewed using a pre-designed proforma. Pain-to-door, and door-to-drug times, were the main outcome measures. The corrected mean (SEM) and median (range) pain-to-door times were 8.5 (0.8) hours and 5.2 (0.5-24) hours, respectively. Out of 104 patients, 38 did not receive thrombolytic therapy. In those who did not receive thrombolytic therapy, prior therapy at local health centers, lack of knowledge of symptoms, and transportation problems were the main reasons for hospital delay. The mean (SEM) and median (range) of door-to-drug times were 1.2 (0.1) hours and 1 (0.2-3.5) hours, respectively.
authors.affiliation: Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh.
authors.forename: S
authors.initials: S
authors.lastname: Malhotra
authors.forename: M
authors.initials: M
authors.lastname: Gupta
authors.forename: K K
authors.initials: KK
authors.lastname: Chandra
authors.forename: A
authors.initials: A
authors.lastname: Grover
authors.forename: P
authors.initials: P
authors.lastname: Pandhi
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D012307:Risk Factors; D015912:Thrombolytic Therapy; D013997:Time Factors