Delay in hospitalization during the acute coronary period.

Abstract Sixty-four patients with definite or probable acute myocardial infarction admitted to a coronary care unit were interviewed with regard to the time intervals and time delays during the pre-hospital period of their acute illness. The average time interval between the onset of symptoms and the patient's arrival in the hospital emergency department was 306 min., and this time was fractionated in a decision time of 200 min., 77 min. of unaccounted for time and 29 min. of transportation time. The decision time was longer in those patients who arrived by car rather than by ambulance, increased progressively with age and was twice as long for women as for men. It was three times longer when the symptom occurred on a weekend as opposed to a weekday, and it was generally longer when the symptom occurred during daylight hours than when it occurred at night. The significance of this prolonged pre-hospital delay during the acute phase of a potentially fatal illness is discussed.