title: Factors influencing pre-hospital delay among patients with acute myocardial infarction in Iran.
abstract: BACKGROUND
  Acute myocardial infarction (AMI) is the leading cause of morbidity and disability among Iranian population. Pre-hospital delay is an important cause of increasing early and also late mortality in AMI. Thus the aim of the present study was to identify the factors influencing pre-hospital delay among patients with AMI in Iran.
  
  
  METHODS
  Between August 2010 and May 2011, a cross-sectional and single-center survey was conducted on 162 consecutive patients with ST-elevation myocardial infarction (STEMI) admitted to Cardiac Care Unit (CCU) of Dr. Heshmat Hospital, Rasht. All patients were interviewed by the third author within 7 days after admission by using a four-part questionnaire including socio-demographic, clinical, situational and cognitive factors. Data were analyzed by descriptive and Logistic regression model at P < 0.05 using SPSS 16.
  
  
  RESULTS
  Mean age was (60.11 ± 12.29) years in all patients. Majority of patients (65.4%) were male. The median of pre-hospital delay was 2 hours, with a mean delay of 7.4 hours (± 16.25 hours). Regression analysis showed that admission in weekend (P < 0.04, OR = 1.033, 95%CI = 1.187 - 2.006) and misinterpretation of symptoms as cardiac origin (P < 0.002, OR = 1.986, 95%CI = 1.254 - 3.155) and perceiving symptoms to not be so serious (P < 0.003, OR = 3.264, 95%CI = 1.492 - 7.142) were factors influencing pre-hospital delay > 2 hours.
  
  
  CONCLUSIONS
  Our findings highlight the importance of cognitive factors on decision-making process and pre-hospital delays. Health care providers can educate the public on AMI to enable them recognize the signs and symptoms of AMI correctly and realize the benefits of early treatment.
authors.affiliation: Nursing Education, Qazvin University of Medical Sciences, Qazvin Nursing and Midwifery College, Qazvin, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Momeni
authors.forename: Arsalan
authors.initials: A
authors.lastname: Salari
authors.forename: Shora
authors.initials: S
authors.lastname: Shafighnia
authors.forename: Atefeh
authors.initials: A
authors.lastname: Ghanbari
authors.forename: Fardin
authors.initials: F
authors.lastname: Mirbolouk
mesh_terms: D000208:Acute Disease / Q000523:psychology*; D000368:Aged; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology*; D013997:Time Factors