Yonsei Med J.  2017 Jul;58(4):710-719. 10.3349/ymj.2017.58.4.710.

Gender Differences in Factors Related to Prehospital Delay in Patients with ST-Segment Elevation Myocardial Infarction

• Kim HS
• Lee KS
• Eun SJ
• Choi SW
• Kim DH
• Park TH
• Yun KH
• Yang DH
• Hwang SJ
• Park KS
• Kim RB

• KMID: 2419075
• DOI: http://doi.org/10.3349/ymj.2017.58.4.710

Abstract

PURPOSE
The aim of our study was to investigate gender differences in factors related to prehospital delay and identify whether the knowledge of acute myocardial infarction symptoms affects this delay in Korean patients with ST-elevation myocardial infarction (STEMI).
MATERIALS AND METHODS
A total of 350 patients (286 men, 64 women) with confirmed STEMI were interviewed to investigate socio-demographics, history of disease, symptom onset time, and factors that contributed to delayed decision time in seeking treatment and hospital arrival time from symptom onset. Factors associated with prehospital delay were examined separately by gender using univariate and multivariate analyses.
RESULTS
Female patients had higher proportions of ≥60-minute decision time and ≥120-minute arrival time compared to male patients (33.9% vs. 23.1%, 60.9% vs. 52.1%, respectively). However, the difference was not statistically significant (p=0.093 and 0.214, respectively). Previous cardiovascular disease (CVD) was associated with increased decision time in men, whereas, in women, lower educational status caused a greater delay in decision time. Factors associated with hospital arrival time excluding delayed decision time were referral from another hospital, previous CVD, and percutaneous coronary intervention in men, and referral from another hospital in women.
CONCLUSION
Gender differences exist in factors related to prehospital delay. Therefore, public education to reduce prehospital delay should be conducted according to gender with a focus on the pertinent factors.

Keyword

Acute coronary syndrome; healthcare timeout; sex differences

MeSH Terms

Aged
Demography
Emergency Service, Hospital
Female
*Hospitalization
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Percutaneous Coronary Intervention
ST Elevation Myocardial Infarction/*diagnostic imaging
*Sex Characteristics
Time Factors

Figure

• 

  Fig. 1 Proportion for patients of the ≥60 minutes of symptoms to decision seek help time and the ≥120 minutes of symptoms to emergency room arrival time between male and female. Error bars on the bar chart is standard error.

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