title: The pre-hospital delay in seeking treatment in patients with acute myocardial infarction referring to a central hospital in Kashan, Iran.
abstract: BACKGROUND
  A cardiovascular disease, especially the acute myocardial infarction (AMI), is the most important health problem worldwide. Pre-hospital delay in seeking medical treatment is an effective factor on patients' outcomes. The aim of this study was to identify the patients' reactions to the signs and symptoms of AMI and identifying the factors contributing to the pre-hospital delay in a central hospital in Kashan, Iran.
  
  
  METHODS
  In this cross-sectional study, a random sample of 248 patients suffering from AMI was recruited. A questionnaire used, which contained demographic data, the time, and place of experiencing the symptoms, and the manner of responding to the initial symptoms. The SPSS software (version, 19 was used for data analysis.
  
  
  RESULTS
  248 patients participated in the study, 183 (73.8%) were males and 65 (26.2%) were females. The mean delay time was 127 ± 174 min. Moreover, 162 patients had arrived at the hospital during the first 60 min after the onset of the symptoms. The variables of being female (P = 0.024), low level of education (P = 0.014), living in urban area (P = 0.01) and referring to the hospital by one's own car instead of using ambulance were accompanied by more pre-hospital delay. 63 patients (25.4%) referred to the hospital by ambulance.
  
  
  CONCLUSIONS
  Despite having only 25% of the patients referring to this center by ambulance, most patients arrived on time to the hospital.
authors.affiliation: School of Nursing and Midwifery, Tehran University of Medical Sciences, Iran.
authors.forename: Mansour
authors.initials: M
authors.lastname: Dianati
authors.forename: Gholam Abbas
authors.initials: GA
authors.lastname: Mosavi
authors.forename: Ali
authors.initials: A
authors.lastname: Hajibagheri
authors.forename: Negin Masoudi
authors.initials: NM
authors.lastname: Alavi
mesh_terms: D000368:Aged; D000552:Ambulances / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000639:trends*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013997:Time Factors