A Survey on the Delay Time Before Seeking Treatment and Clinical Symptoms in Patients with Acute Myocardial Infarction

급성 심근경색증환자의 임상적 증상과 치료추구시간의 지연

Many patients of acute myocardial infarction showed delay time before seeking treatment although they needed immediate thrombolytic therapy once they perceived their symptoms. The objectives of this study were to identify the relationship between clinical symptoms and the delay, and to find the time spent before seeking the treatment. This study was a retrospective research. The delay time for the treatment consisted of the length of delay from symptom onset to patients' decision (T1), from patients' decision making to finding transportation (T2), and from taking transportation to the first hospital arrival(T3). The subjects were 89 patients who were admitted in the ICU and Cardiac Ward at Chonnam University Hospital with the first attack of acute myocardial infarction. Center, USA The data was collected for three months from March 1st to May 31st of 1998 through questionnaires and reviewing patients' charts: The chart information was suppled by two nurses working at the ICU and Cardiac Ward. The data was analyzed by using frequency, mean and ANOVA through the SAS program. The results of study summarized as follows: 1. Sixty two patients (69.7%) were male and twenty seven patients (30.3%) were female, the ratio of male to female was 2.3 : 1. 2. In daily life, the 70.8% of the patients felt chest pain and discomfort fatigue in 67.4%, dyspnea in 57.3%, and pain in arm, neck, and jaw in 52.8%. During the attack, 97.8% of the patients felt chest pain and discomfort dyspnea in 82.1%, pain in arm, neck, jaw in 67.4% and perspiration in 51.7%. 3. The length of time a patient spent seeking time for treatment (T1+T2+T3) was 94.6 minutes, in which the time for patients' decision making for treatment (T1) was 70.3 minutes, time for finding transportation (T2) was 8.2 minutes, and time for the transportation of the patient to the first hospital (T3) was 16.1 minutes. Time for patients' decision making to go to a hospital(T1) was 74.2% of the total time sought for treatment. 4. The differences of time sought for treatment between perceptions about the seriousness of the symptoms were significant (F= 6.5, p< .01). The more serious the heart symptoms they felt, the shorter the seeking time for treatment. 5. The differences of the time delay before treatment between the degree of the symptoms were significant (F= 2.9, p< .05). The patients with the typical chest pain and discomfort spent shorter the seeking time for treatment than those with the atypical symptoms of acute myocardial infarction. 6. The differences of transportation time to the first hospital between the types of cars that the patients used, were significant (F= 4.3, p< .01). When the patients used 119 or 129 they spent the least time (5.3 minutes) for transportation, and followed by way of an ambulance (15.6 minutes), private car (20.6 minutes), and taxi (24.8 minutes).