Prevalence and Factors Related to Pre-Hospital Delay in Young Patients with ST-Elevation of Myocardial Infarction (STEMI)
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Abstract
Introduction: ST-Elevation Myocardial Infarction (STEMI) often leads to out-of-hospital cardiac arrests, particularly among younger individuals with comorbidities such as diabetes mellitus (DM), hypertension (HPT) and smoking. This study aimed to determine the prevalence and factors associated with pre-hospital delays in young STEMI patients. Method: A retrospective study was conducted involving patients age between 19 to 55, admitted between 1st January 2020 and 31st December 2022 to the Coronary Care Unit (CCU), Hospital Raja Permaisuri Bainun in Ipoh, Perak. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 29. Results: A total of 340 patients’ medical records were reviewed. The majority of patients were male (93.2%), aged 46-55 (57.1%) and Malay (58.8%). Smoking (69.7%), HPT (43.8%), and DM (34.1%) were the most prevalent comorbidities. The in-hospital mortality rate was 3.2%. The prevalence of pre-hospital delay was 44.7% with a median delay of 7.01 h (IQR: 10.34 h). Patients with DM [OR: 1.72 (95% CI: 1.02, 2.90)], responding with "did nothing, hope it will go away" [OR: 3.63 (95% CI: 1.36, 9.69)], "lay down and tried to relax" [OR: 2.94 (95% CI: 1.43, 6.07)] and first medical contact (FMC) with a general practitioner (GP) [OR: 11.32 (95% CI: 2.20, 58.27)] were significantly associated with prolonged hospital delays (p <0.05). Conclusion: We recommend public awareness campaigns for younger population to improve early recognition of STEMI symptoms and enhanced training for GPs to improve early diagnosis especially the utilization of electrocardiograms (ECGs) to facilitate appropriate referral.
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