Frequency, causes, and predictors of pre-hospital delay in patients with acute myocardial infarction at cardiology centers in Khartoum state, the capital of Sudan: A hospital-based cross sectional study

Abstract

Abstract Background: Early treatment of acute myocardial infarction is crucial to reduce mortality in these patients. However, not all patients arrive early enough to receive optimal therapy, especially in developing countries. Many factors can lead to increased pre-hospital delay. This study aimed to detect the frequency of delayed patients out of the total acute myocardial infarction patients, in addition to determining which causes were behind the delay and which factors can be associated with the delay. Methods: This study enrolled patients admitted to Al-Shaab Teaching Hospital and the Sudan Heart Center from the beginning of September 2022 to the end of November 2022. The validated questionnaire was completed using an interview method. Patients were classified as delayed (interval of 12 hours or more) and non-delayed (interval of < 12 hours). Causes behind the delay were searched for in delayed patients, and different associations were studied using the chi-square test. Results: A total of 224 patients were involved. Of these, 119 (53%) arrived late. Going to a non-reperfusion center was the most commonly observed cause behind the delay (64%). A statistically significant association was found between delay and level of education (p-value 0.03), smoking status (p-value 0.004), and location of residency (p-value 0.04). On the other side, no significant association was found with age, gender, mood of transportation, chronic comorbidities, previous myocardial infarction, and 1st-degree family history of myocardial infarction (all p-values > 0.05). Conclusions: More than half of the patients exhibited delayed arrival. This delay was mostly attributed to going to non-reperfusion centers. A strong association was also found between delay, illiteracy, non-smoking, and living outside Khartoum. More efforts must be directed toward educating people about coronary artery diseases, especially acute myocardial infarction, with its different aspects and the advantages of early arrival to the hospital and early management.