title: [Delays in acute myocardial infarction treatment: results of a multicenter study in the district of Tunis (Tunisia)].
abstract: OBJECTIVE
  We aimed to assess the acute myocardial infarction management in Tunis public hospitals during one year (from March 2000 to February 2001).
  
  
  METHODS
  A standard questionnaire was designed to record prospective data on 740 patients with a follow up during 28 days. Multivariate analysis was performed using the logistic regression model with all-factors as well as age, gender, CHD risk factors as predictors of the delay and fatality. 54% of patients were admitted during the first 6 hours after the onset of symptoms. In multivariate analysis, the delay of consultation is significantly correlated with gender (OR = 2.3, p < 0.001), age (OR = 1.02, p < 0.01) and health insurance (OR = 1.5, p < 0.01). 90% of patients consulted in emergency wards. The emergency ambulance transported 19.6% of patients. 48% of patients underwent early revascularisation of thrombolysis, 51% on men vs 31% on women (p < 0.01). The fatality rate was higher on women 14% vs 6.4% on men (p < 0.01) at 5 days and 27.2% vs 13.6% at 28 days. In multivariate analysis, the principal fatality predictive factor was age (RR = 1.08, p < 0.001) and delay (2.56 p < 0.001) and tobacco smoking (RR = 2.83, p < 0.0001).
  
  
  CONCLUSIONS
  This study highlighted the problem of acute myocardial infarction management in public hospitals in Tunisia and it constitutes a baseline to assess different interventions focusing on cardiovascular diseases control and surveillance.
authors.affiliation: Institut National de Santé Publique.
authors.forename: Souha
authors.initials: S
authors.lastname: Bougatef
authors.forename: Habiba
authors.initials: H
authors.lastname: Ben Romdhane
authors.forename: Nacer
authors.initials: N
authors.lastname: Kafsi
authors.forename: Ali
authors.initials: A
authors.lastname: Belhani
authors.forename: Habib
authors.initials: H
authors.lastname: Haouala
authors.forename: Mohamed Lotfi
authors.initials: ML
authors.lastname: Slimane
authors.forename: Rachid
authors.initials: R
authors.lastname: Boujnah
authors.forename: Habiba
authors.initials: H
authors.lastname: Drissa
authors.forename: Noureddine
authors.initials: N
authors.lastname: Achour
authors.forename: Mohamed
authors.initials: M
authors.lastname: Gueddiche
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014416:Tunisia / Q000453:epidemiology