Factors Responsible for Prehospital Delay in Patients with Acute Coronary Syndrome in Bangladesh
Abstract
:1. Introduction
2. Materials and Methods
2.1. The Study Settings
2.2. Patient Selection
2.3. Data Collection
2.4. Statistical Analysis
3. Results
3.1. Demographic Information of the Patients
3.2. Association between Sociodemographic Characteristics and Prehospital Delay
3.3. Association between Chronic Diseases and Prehospital Delay
3.4. Association between other Miscellaneous Factors and Prehospital Delay
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | n (%, 95% Confidence Interval) | |
---|---|---|
Gender | Female | 123 (18.1, 15.42–21.22) |
Male | 555 (81.9, 78.78–84.58) | |
Marital Status | Single | 3 (0.4, 0.15–1.29) |
Married | 666 (98.2, 96.93–98.98) | |
Widow | 9 (1.3, 0.69–2.50) | |
Residence | Rural | 537 (79.2, 75.98–82.09) |
Urban | 129 (19.0, 16.25–22.15) | |
Education | Illiterate | 315 (46.5, 42.74–50.22) |
Primary | 150 (22.1, 19.16–25.40) | |
Up to SSC | 147 (21.7, 18.74–24.93) | |
Above SSC | 66 (9.7, 7.72–12.20) | |
Occupation | Unemployment | 93 (13.7, 11.33–16.51) |
Day labor | 204 (30.1, 20.76–33.65) | |
housewife | 105 (15.5, 12.96–18.40) | |
Job | 66 (9.7, 7.72–12.20) | |
Business | 204 (30.1, 26.76–33.65) | |
Age | <40 years | 84 (12.4, 10.11–15.08) |
40–60 years | 378 (55.8, 51.99–59.45) | |
>60 years | 216 (31.9, 28.46–35.46) | |
Income (Bangladeshi Taka) | <20,000 | 606 (89.4, 86.84–91.48) |
20,000–30,000 | 51 (7.5, 5.77–9.76) | |
>30,000 | 21 (3.1, 2.03–4.69) | |
Body Mass Index | Normal | 292 (43.1, 39.39–46.82) |
Overweight | 356 (56.9, 53.18–60.61) | |
Prehospital delay | <12 h | 420 (61.9, 58.23–65.52) |
>12 h | 258 (37.5%, 33.89–41.17) |
Variables | Categories | N | Prehospital Delay | p-Value | ||
---|---|---|---|---|---|---|
<12 h (n, %) | >12 h (n, %) | Univariate Analysis | Multivariate Analysis | |||
Gender | Female | 123 | 84 (68.3) | 39 (31.7) | 0.135 | 0.242 |
Male | 555 | 339 (61.1) | 216 (38.9) | |||
Age | <40 | 84 | 60 (71.4) | 24 (28.5) | 0.001 | 0.127 |
40–60 | 378 | 200 (52.9) | 178 (47.1) | |||
>60 | 216 | 100 (46.3) | 116 (53.7) | |||
Residence | Rural | 537 | 318 (59.2) | 219 (40.8) | 0.001 | 0.001 |
Urban | 129 | 99 (76.7) | 30 (23.3) | |||
Education | Illiterate | 315 | 180 (57.1) | 135 (42.9) | 0.001 | 0.001 |
Primary | 150 | 99 (66) | 51 (34) | |||
Secondary | 147 | 87 (59.2) | 60 (40.8) | |||
Above Secondary | 66 | 57 (86.4) | 9 (13.6) | |||
Employment | Unemployment | 93 | 30 (32.3) | 63 (67.7) | 0.001 | 0.001 |
Day labor | 204 | 120 (58.8) | 84 (41.2) | |||
Housewife | 105 | 72 (68.6) | 33 (31.4) | |||
Job | 66 | 54 (81.8) | 12 (18.2) | |||
Business | 204 | 150 (73.5) | 54 (26.5) |
Variables | Categories | N | Prehospital Time | p-Value | ||
---|---|---|---|---|---|---|
<12 h (n, %) | >12 h (n, %) | Univeriate Analysis | Multivariate Analysis | |||
History of Mycordial Infarction | Absent | 579 | 375 (64.8) | 204 (35.2) | 0.011 | 0.024 |
Present | 99 | 51 (51.5) | 48 (48.5) | |||
Hypertesion | Normotensive | 381 | 240 (63) | 141 (37) | 0.714 | 0.272 |
Hypertensive | 297 | 183 (61.6) | 114 (38.4) | |||
Diabetes Mellitus | Non-diabetic | 468 | 285 (60.9) | 183 (39.1) | 0.231 | 0.152 |
Diabetic | 210 | 138 (65.7) | 72 (34.3) | |||
Dyslipidaemia | Absent | 531 | 327 (61.6) | 204 (38.4) | 0.409 | 0.228 |
Present | 147 | 96 (65.3) | 51 (34.7) | |||
Family History | No history | 489 | 294 (60.1) | 195 (39.9) | 0.051 | 0.049 |
History | 189 | 129 (68.3) | 60 (31.7) | |||
Smocking | Non-smoker | 243 | 153 (62.9) | 90 (37.1) | 0.850 | 0.339 |
Smoaker | 405 | 252 (62.2) | 153 (37.8) | |||
Chronic Kidney Disease | No | 642 | 399 (62.1) | 243 (37.9) | 0.586 | 0.399 |
Yes | 36 | 24 (66.7) | 12 (33.3) | |||
Thyroid Disorder | Hyperthyroid | 45 | 24 (53.3) | 21 (46.7) | 0.409 | 0.271 |
Euthyroid | 615 | 387 (62.9) | 228 (37.1) | |||
Hypothyroid | 18 | 12 (66.7) | 6 (33.3) | |||
Physical Activity | Sedentary | 198 | 114 (57.6) | 84 (42.4) | 0.156 | 0.110 |
Regular activity | 306 | 192 (62.7) | 114 (37.3) | |||
Irregular activity | 174 | 117 (67.2) | 57 (32.8) | |||
Chest Pain | Absent | 273 | 105 (38.5) | 168 (61.5) | 0.001 | 0.001 |
Present | 402 | 252 (62.7) | 150 (37.3) | |||
Breathlessness | Absent | 513 | 321 (62.6) | 192 (37.4) | 0.618 | 0.281 |
Present | 159 | 96 (60.4) | 63 (39.6) | |||
Palpitation | Absent | 612 | 384 (62.7) | 228 (37.3) | 0.560 | 0.274 |
Present | 66 | 39 (59.1) | 27 (40.9) |
Variables | Categories | N | Prehospital Time | p-Value | ||
<12 h (n, %) | >12 h (n, %) | Univariate Analysis | Multivariate Analysis | |||
Place of first onset of symptom | At home | 558 | 210 (37.6) | 348 (62.4) | 0.001 | 0.001 |
At work | 120 | 75 (62.5) | 45 (37.5) | |||
Status of first medical contact | Upazila | 153 | 108 (70.6) | 45 (29.4) | 0.001 | 0.074 |
District | 75 | 54 (72) | 21 (28) | |||
Medical college | 315 | 207 (65.7) | 108 (34.3) | |||
Private physician | 135 | 54 (40.0) | 81 (60.0) | |||
Distance from place of symptom to first medical contact | <5 km | 366 | 240 (65.6) | 126 (34.4) | 0.001 | 0.001 |
<15 km | 126 | 48 (38.1) | 78 (61.9) | |||
>15 km | 186 | 60 (32.3) | 126 (67.7) | |||
Delay in making decision to get medical help | No delay | 363 | 192 (52.9) | 171 (47.1) | 0.001 | 0.001 |
Delay | 102 | 33 (32.4) | 69 (67.6) | |||
Ignorance of symptoms | Not ignored | 288 | 162 (56.3) | 126 (43.8) | 0.001 | 0.001 |
Ignored | 177 | 60 (33.8) | 117 (66.2) | |||
Previous hospitalization | No history | 543 | 204 (37.6) | 339 (62.4) | 0.001 | 0.001 |
History | 135 | 84 (62.2) | 51 (37.8) | |||
Mode of transportation | Ambulance | 39 | 36 (92.3) | 3 (7.7) | 0.012 | 0.001 |
Private | 516 | 333 (64.5) | 183 (35.5) | |||
Public | 36 | 15 (41.6) | 21 (58.4) |
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Khaled, M.F.I.; Adhikary, D.K.; Islam, M.M.; Alam, M.M.; Rahman, M.W.; Chowdhury, M.T.; Perveen, R.; Ahmed, S.; Ashab, E.; Shakil, S.S.; et al. Factors Responsible for Prehospital Delay in Patients with Acute Coronary Syndrome in Bangladesh. Medicina 2022, 58, 1206. https://doi.org/10.3390/medicina58091206
Khaled MFI, Adhikary DK, Islam MM, Alam MM, Rahman MW, Chowdhury MT, Perveen R, Ahmed S, Ashab E, Shakil SS, et al. Factors Responsible for Prehospital Delay in Patients with Acute Coronary Syndrome in Bangladesh. Medicina. 2022; 58(9):1206. https://doi.org/10.3390/medicina58091206
Chicago/Turabian StyleKhaled, Md. Fakhrul Islam, Dipal Krishna Adhikary, Md. Mazharul Islam, Md. Mashiul Alam, Mohammad Walidur Rahman, MSI Tipu Chowdhury, Roseyat Perveen, Sharmin Ahmed, Eshita Ashab, Shiblee Sadeque Shakil, and et al. 2022. "Factors Responsible for Prehospital Delay in Patients with Acute Coronary Syndrome in Bangladesh" Medicina 58, no. 9: 1206. https://doi.org/10.3390/medicina58091206