title: International comparison of factors associated with delay in presentation for AMI treatment.
abstract: BACKGROUND
  Prehospital delay in response to acute myocardial infarction (AMI) symptoms is well documented in the US and Europe, but little is known about it in Asian countries where cardiovascular disease is increasing.
  
  
  OBJECTIVE
  We conducted an observational study of delay times and factors associated with hospital presentation times in 595 patients with AMI from the US, England, Japan and South Korea.
  
  
  METHODS
  Patients were interviewed about responses to symptoms within 72 h of hospital admission and the medical records were reviewed.
  
  
  RESULTS
  The proportions of patients with delay times of 1 h or less were: US--23%, Korea--18%, England--15% and Japan--8%. In the US and England when others present at symptom onset called an ambulance patients presented two to three times sooner. Independent predictors of presentation within an hour of symptom onset were attribution of symptoms to the heart and not waiting for symptoms to go away.
  
  
  CONCLUSIONS
  Similar education about the need to seek treatment early in response to AMI symptoms may be applicable in Western and Eastern industrialised populations.
authors.affiliation: Faculty of Nursing, Midwifery and Health, University of Technology Sydney, and Northern Sydney Area Health Service, Sydney, Australia. sharon.mckinley@uts.edu.au
authors.forename: Sharon
authors.initials: S
authors.lastname: McKinley
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dracup
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Carol
authors.initials: C
authors.lastname: Ball
authors.forename: Keiko
authors.initials: K
authors.lastname: Yamasaki
authors.forename: Cho Ja
authors.initials: CJ
authors.lastname: Kim
authors.forename: Maree
authors.initials: M
authors.lastname: Barnett
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D003431:Cross-Cultural Comparison; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006764:Hospitals, Community; D006786:Hospitals, Urban; D006801:Humans; D007723:Korea / Q000208:ethnology; D016015:Logistic Models; D008131:London / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009203:Myocardial Infarction / Q000208:ethnology* / Q000628:therapy; D009820:Ohio / Q000208:ethnology; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014041:Tokyo / Q000208:ethnology