title: Factors influencing the use of ambulance among patients with acute coronary syndrome: results of two centers in Turkey.
abstract: OBJECTIVE
  In this study, we aimed to identify the factors influencing the use of ambulance among patients admitted to two Turkish hospitals with acute coronary syndrome (ACS).
  
  
  METHODS
  Overall, 330 with a mean age of 55±13 years, hospitalized patients with ACS at 2 different hospitals were included in this prospective cohort study. The factors influencing the use of ambulance hospital were investigated through a questionnaire. The comparisons were made between two groups regarding use of ambulance. The predictors of the use of ambulance were determined using multiple logistic regression analysis.
  
  
  RESULTS
  Despite the high rate of knowing the emergency service number of "112", of the 330 patents, only 96 (29%) used ambulance. Ambulance users had shorter arrival duration with median of 60 min vs 120 min (p=0.03). Presenting with ST elevation myocardial infarction (OR=3.127, 95% CI: 1.555-6.2877, p<0.001), severity of chest pain (OR=2.665, 95% CI: 1.938-3.665, p<0.001), presence of accompanying symptoms such as dyspnea (OR= 5.510, 95% CI: 2.614-11.614, p<0.001), dizziness (OR=4.172, 95% CI: 1.901-9.154, p<0.001) and vomiting (OR=3.756, 95% CI: 1.521-9.272, p=0.004), knowledge of cardiac risk factors (OR=10.512, 95% CI: 4.497-24.572, p<0.001) or chest pain related to heart attack and the importance of quickly seeking for medical care by calling ambulance (OR= 4.184, 95% CI: 2.528-6.926, p<0.001) are the factors associated with ambulance use.
  
  
  CONCLUSIONS
  Using ambulance was in a very low rate among our study patients with ACS. Severity of symptoms, type of ACS and knowledge are seemed to be related with increased ambulance use. Informative health educational programs can be organized to achieve a behavioral change in using of ambulance.
authors.affiliation: Clinic of Cardiology, Türkiye Yüksek İhtisas Hospital, Ankara-Turkey. burcume@gmail.com.
authors.forename: Burcu
authors.initials: B
authors.lastname: Demirkan
authors.forename: Meltem Refiker
authors.initials: MR
authors.lastname: Ege
authors.forename: Pınar
authors.initials: P
authors.lastname: Doğan
authors.forename: Esra Gücük
authors.initials: EG
authors.lastname: İpek
authors.forename: Umit
authors.initials: U
authors.lastname: Güray
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Güray
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality* / Q000628:therapy; D000552:Ambulances / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D014421:Turkey