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European Heart Journal 1994 15(12):1595-1598;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Factors delaying treatment of acute myocardial infarction

B. SCHWARZ, R. SCHOBERBERGER, A. RlEDER and M. KUNZE

Institut für Sozialmedizin, Medical School, Vienna University Vienna, Austria

Received 21 February 1994; revised 24 May 1994; .

Correspondence: Berahard Schwarz, Institut fuür Sozialmedizin, Medical School, University Vienna, Alser Strasse 21/12, A-1080 Vienna, Austria.

Abstract

The study was set up to investigate factors delaying treatment of acute myocardial infarction. Nine hundred and sixty-seven Austrian physicians submitted data on their most recent case of myocardial infarction in a cross-sectional study.

Mean time for seeking medical care was 111 minfrom onset; mean admission time to the hospital was 136 min. The degree of anxiety and fear perceived by the patient was positively associated with an earlier decision. Adjusted means of decision time according to degree of fear ranged from 29 to 133 min, adjusted means of admission time from 77 to 153 min. Decision time and admission time were negatively associated with the presence of typical symptoms and a history of myocardial infarction. Adjusted means of decision time according to symptom-history category ranged from 75 to 134 min, adjusted means of admission time from 110 to 151 min. Admission time was also higher in men when patients lived alone, and if the journey to the hospital was a 40 min or more car drive (i.e. 90th percentile).

We conclude that measures that increase awareness in patients at risk are vital to reduce delays in seeking medical care and hospital admission, and thus to improve the prognosis of acute myocardial infarction.

Key Words: Myocardial infarction • delay • epidemiology • psychology


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