Factors Associated with Delayed Hospital Arrival Among Patients with Acute Coronary Syndrome in Addis Ababa

Abstract

Abstract

Background: Acute coronary syndrome remains one of the most significant health burdens of society with significant mortality and morbidity. Lack of awareness about the symptoms and non-availability of infrastructure are associated with a delayed presentation to hospital from  the onset of symptoms in different research.

Objectives: To understand the importance of timely presentation in the management of acute coronary syndrome (ACS) and identify the barriers and facilitators that contribute to delayed presentation, leading to potential adverse outcomes in selected hospitals of Addis Ababa.

Methods: The study is a prospective cross-sectional study of ACS patients who were treated at the four mentioned hospitals. Data was collected from the patients who were being treated in the mentioned hospitals during the study period. Semi-structured questionaries were administered by translating to their preferred language. Data was cleaned, coded, and entered into SPSS version 27. Basic sociodemographic and clinical characteristics were described using frequency, mean, median, percentile, and standard deviation. The association between sociodemographic factors was determined using bivariate and multivariate logistic regression.

Results: Out of the 114 participants 31% are females and the rest are males. Majorities of the study participants (54%) are age between 40 and 60 years old. Most patients came from Addis Ababa and most of the study participants are married and 33% are government employees.

The average time of presentation is 14 hours from the onset of symptoms and 88% of the cases presented after 4 hours of symptom onset. 57% of the patients presented after 12 hours from onset of symptoms.  Chest pain was the primary complaint in 88 patients (77.9%) The overall complication was 30.7%. ADHF was the most prevalent complication. Level of education, insurance availability, and mode of transport were the most important determinants of prehospital delay.

Conclusion: The study found that acute coronary syndrome is common in older age greater than 40 years and it is predominant in males. It has also shown that lack of health insurance coverage low level of education and living in rural areas are associated with delayed hospital arrival.