title: Factors associated with delayed hospital arrival among patients with acute myocardial infarction: a cross-sectional study in Greece.
abstract: BACKGROUND
  It is proven that early admission to hospital contributes significantly to the successful management of acute myocardial infarction (AMI).
  
  
  OBJECTIVE
  This study aimed to examine the factors associated with delayed hospital arrival among patients with AMI.
  
  
  METHODS
  A cross-sectional study among 477 AMI patients was conducted during a 2-year period in two large tertiary hospitals in Greece. Structured face-to-face interviews were conducted and information regarding their socio-demographic characteristics, medical history and factors that might be correlated with delayed hospital arrival were collected.
  
  
  RESULTS
  The main factors that were found to be correlated with delayed hospital arrival among AMI patients were the absence of companion/attendant/escort present during the AMI [odds ratio (OR) 2.1, 95% confidence interval (CI) 0.98-4.4, P = 0.049], previous medical history of diabetes mellitus (OR 3.4, CI 1.6-7.2, P = 0.002), absence of dyspepsia (OR 9.2, CI 3.6-23.3, P < 0.001) and nausea/vomiting symptoms (OR 16.9, CI 4.1-69.1, P < 0.001), and also being at a distance of more than 10 km from the hospital (OR 19.6, CI 5.4-70.6, P < 0.001).
  
  
  CONCLUSIONS
  A number of factors that might delay hospital arrival among patients with AMI should be taken into account in healthcare service planning. Health policy actions that will improve the accessibility to healthcare services, the restructuring of the Greek primary healthcare system and the provision of effective patient education by nurses could reduce the pre-hospital delay.
  
  
  CONCLUSIONS
  The study was conducted in two hospitals which limits the generalization of the findings. Also, the onset of AMI symptoms relied on self-report by the patients.
authors.affiliation: Faculty of Nursing, National & Kapodistrian University of Athens, Athens, Greece.
authors.forename: H
authors.initials: H
authors.lastname: Brokalaki
authors.forename: K
authors.initials: K
authors.lastname: Giakoumidakis
authors.forename: N V
authors.initials: NV
authors.lastname: Fotos
authors.forename: P
authors.initials: P
authors.lastname: Galanis
authors.forename: E
authors.initials: E
authors.lastname: Patelarou
authors.forename: E
authors.initials: E
authors.lastname: Siamaga
authors.forename: I S
authors.initials: IS
authors.lastname: Elefsiniotis
mesh_terms: D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D005260:Female; D006115:Greece; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D012959:Socioeconomic Factors; D013997:Time Factors