Assessment of hospital arrival time and associated factors of patients with acute myocardial infarction (STEMI) to introduce thrombolytic therapy at Jimma Medical Center, Jimma, Ethiopia

Abstract

Abstract Background Acute cardiovascular emergencies, including ST-segment elevation myocardial infarction (STEMI) and acute ischemic stroke, are common conditions requiring timely medical intervention. Thrombolytic therapy is an important treatment option for these conditions, although its effectiveness depends on prompt hospital arrival. This study aimed to assess the arrival time and associated factors in patients with ACS-STEMI at the Jimma Medical Center, with the objective of determining the need and applicability of thrombolytic therapy. Methodology : This hospital-based cross-sectional study was conducted at the Jimma Medical Center between September 1st and January 30, 2023. All patients diagnosed with ACS-STEMI during the study period were included. Data were collected using structured questionnaires and were entered into Epi-data version 3.1 for analysis. Chi-square tests and logistic regression models were used to examine the relationships between the variables. Results Among 63 patients admitted with ACS-STEMI, males accounted for 57.1%, and 42,9% of all admissions were in the 55—64 age group. More than two-thirds of the participants did not attend formal education, and hence could not read and write, and most (68%) used public transport to reach the medical center. Most participants had a very low monthly income of less than 50 USD. Approximately 62% of the study participants arrived at the Medical Center 12 h after the onset of chest pain (average time of arrival was approximately 33 h and 21 min). The sudden onset of symptoms and proximity to the Medical Center (within 5 km) were related to a shorter time of arrival, while those with diabetes mellitus had a longer time of arrival. Conclusion The time of arrival was longer in the patients with ACS-STEMI. Level of education, misinterpretation of symptoms, and lack of public health insurance were the major correlates of prehospital delays. This emphasizes the need to improve public health literacy, health insurance coverage, and the availability of standby emergency public ambulances, which shortens the time-to-needle and leads to early medical intervention that reduces morbidity and mortality, while improving survival and quality of life.