title: Gender differences in factors associated with prehospital delay among acute coronary syndrome patients in Pakistan.
abstract: OBJECTIVE
  To identify gender differences in prehospital delay time (PDT) and its associated factors among acute coronary syndrome (ACS) patients.
  
  
  METHODS
  Descriptive cross-sectional comparative study.
  
  
  METHODS
  This study was conducted among 249 ACS patients at two tertiary care hospitals of a large metropolitan city of Pakistan. Data were collected through the modified Response to Symptoms Questionnaire.
  
  
  RESULTS
  The median PDT of women was found to be 7 hours, compared to 3.5 hours among men (p = .001). Results of the regression analysis indicated that most women delayed because of social factors, such as attendants' responses to their symptoms (p = .002), and because they were worried about expenses required for the treatment (p = .002); yet, most men delayed owing to individual factors, such as waiting for symptoms to subside (p< .001), and not recognizing the symptoms as being cardiac related (p< .001). Having anxiety and lack of knowledge about symptoms was associated with extended PDT among both genders.
  
  
  CONCLUSIONS
  Women delayed longer than men in seeking treatment for their ACS symptoms. Different factors were associated with PDT in women and men. This study may provide important insights for designing interventional studies to reduce PDT in Pakistani ACS patients.
authors.affiliation: Aga Khan University, Karachi, Pakistan saleema.allana@aku.edu.
authors.forename: Saleema
authors.initials: S
authors.lastname: Allana
authors.affiliation: Al-Noor Hospital, Al Ain, United Arab Emirates.
authors.forename: Khurshid
authors.initials: K
authors.lastname: Khowaja
authors.affiliation: Aga Khan University, Karachi, Pakistan.
authors.forename: Tazeen Saeed
authors.initials: TS
authors.lastname: Ali
authors.affiliation: University of Kentucky, Lexington, KY, USA.
authors.forename: Debra Kay
authors.initials: DK
authors.lastname: Moser
authors.affiliation: Aga Khan University, Karachi, Pakistan.
authors.forename: Aamir Hameed
authors.initials: AH
authors.lastname: Khan
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000523:psychology*; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan; D010342:Patient Acceptance of Health Care; D012044:Regression Analysis; D012737:Sex Factors; D013997:Time Factors
keywords: acute coronary syndrome; associated factors; gender differences; prehospital delay