Pre-Hospital Delay And Its Associated Factors In Patients With Acute Coronary Syndrome

OBJECTIVE To evaluate factors associated with pre-hospital delay in patients with acute coronary syndrome (ACS). METHOD A hospital-based cross-sectional survey was conducted in Sanglah Hospital during the period December 2017 to May 2018. For collecting data concerning factors associated with pre-hospital delay in ACS patients, interviews were conducted with a set of validated questionnaires. Spearman and contingency coefficient tests were used to analyze the data, and multiple logistic regression was employed to determine the dominant factors. RESULTS During the study period, a total of 230 participants with pre-hospital delay and 62 participants with no delay were enrolled in the study. Increased risk of pre-hospital delay was observed in women, in subjects with a monthly income less than 1.5 million and 1.6-2.5 million, senior high school the highest educational attainment, the Indonesian national health insurance, badan penyelenggara jaminan sosial (BPJS), private transportation, and behavioral factors, including taking a rest and self-medication. Lower risk of pre-hospital delay was found in men, entrepreneurs, those with monthly income 2.6-3.5 million and more than 3.5 million, higher (university) education, non-BPJS insurance, ambulance transportation, and use of emergency medical services. Logistic regression analysis revealed that the dominant risk factor for pre-hospital delay was patients taking a rest when suffering chest pain. CONCLUSIONS Taking a rest when suffering chest pain is the dominant factor associated with pre-hospital delay in patients with ACS.