ACUTE MYOCARDIAL INFRACTION AND HOSPITAL STAY

Objective: To evaluate the factors associated with pre-hospital time (PHT) in our community. Materials and Methods: The research was carried out at Cardiology Department of Nishtar Hospital, Multan. Patients suffering from acute STEMI (Heart attack due to complete blockage of the blood supply) were marked as the subjects of the study. There was no restriction of age on the sample. In each case, time was calculated from the start of symptoms till arrival at emergency department of Nishtar Hospital Multan. In addition, factors responsible for delay during PHT were inquired and analyzed. Economical, remoteness, lack of awareness, local doctors and quakes, no helper nearby, and others i.e. mode of transportation etc. were the major contributing factors for the delay. Results: The mean age of the sample was calculated to be 55±12 years. Out of 185 of total subjects, 130(70.30%) were males and 55(29.7%) were females. The other associated diseases found for the STEMI patients in our study were smoking 102(55.1%), high blood pressure 81(43.8%) and diabetes 52(28.1%). The patients who reported within 4 hours were 43.8%, 4-8 hours were 23.2%, 8-12 hours were 11.4%, 12-16 hours were 9.2%, 16-20 hours were 3.8% whereas 8.6% patients were delayed for more than 20 hours. The MI of anterior wall was most common 111(60%) in our research whereas that of inferior wall was second 46(24.9%). Most of the females were late to reach hospital (72.72%). It was observed that the people who reported late were also suffering from hypertension (58.02%), obesity (56.52%) and diabetics (53.8%). Other factors such as lack of knowledge, longer distance, unavailability of transport etc. also contributed to the cause at a lower level. Conclusion: In this study majority of the population was having PHT more than 4 hours. Lack of knowledge, local doctors and quakes and unawareness about symptoms were the major causes of the delay during PHT. Most of the patients who reported late were females. Key Words: Acute myocardial infarction; prehospital delay; Ischemic heart disease; Diabetes mellitus; Hypertension