[Prehospital delay in patients with ischemic chest pain in the Province of Alicante. Multicenter Study of Prehospital Delay in Patients with chest Pain].

BACKGROUND

The objectives of this study are: 1) to estimate the pre-hospital delay between onset of symptoms and admission in patients with ischemic chest pain in 5 hospitals from the Spanish Region of Valencia, and 2) to determine the socio-demographic variables that are associated with this delay.

PATIENTS AND METHODS

We studied prospectively 426 patients admitted to the emergency area of the 5 participating hospitals with chest pain and a probability of infarction > or = 0.08. In each patient we determined the probability of acute myocardial infarction, the length of time between onset of symptoms and hospital arrival (patient's decision time and transportation time), and some socio-demographic variables presumably related to the delay.

RESULTS

The median between onset of symptoms and arrival to the hospital was 120 minutes, corresponding the biggest part to decision time (median 73 minutes), whilst the median of transportation time was 20 minutes. Cox's regression analysis identified the following independent predictors of delay: age of the patient (p = 0.012), living with relatives (p = 0.026), onset during the night (p < 0.001) or at home (p = 0.021), low severity of pain (p < 0.001), being autoctonous (p = 0.023) and participation of health care individuals in the referral process (p = 0.011).

CONCLUSIONS

The pre-hospital delay detected in our study is comparable to that detected in other settings. The determinants of the delay identified in this study are consistent with previously published findings.