What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Acute Myocardial Infarction (n=1229). Intervention: Female sex vs. Male sex. Primary outcome: Delayed presentation (triage levels 3, 4, or 5) (OR 0.69, 95% CI 0.51 to 0.93, p=0.016).

What does this research mean for the field?

Female patients with acute myocardial infarction have significantly lower odds of delayed emergency department presentation compared to male patients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the association between sex and delayed presentation, approximated using emergency department triage acuity, in patients with acute myocardial infarction.

June 25, 2026CureusOpen Access

Association Between Sex and Prehospital Delay in Patients With Acute Myocardial Infarction: A Cross-Sectional Analysis of the National Hospital Ambulatory Medical Care Survey, 2006-2020

Q: What are the key findings of this study?

Female patients with acute myocardial infarction had significantly lower odds of delayed presentation to the emergency department compared to male patients (adjusted OR 0.69).

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Key result

Female sex is linked to ~31% lower odds of delayed acute MI presentation vs males.

OR 0.69
95% CI 0.51 to 0.93
P=0.016
n=1,229

Why the study?

Differences in prehospital delay by sex in acute myocardial infarction have been reported, but findings remain inconsistent across studies.

Does female sex reduce prehospital delay (approximated by triage acuity) in adults presenting with acute myocardial infarction?

Key Points

To evaluate the association between sex and delayed presentation, approximated using emergency department triage acuity, in patients with acute myocardial infarction.
Analyzed cross-sectional data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) across 2006 to 2020.
Evaluated 1,229 adult visits representing 6,344,820 weighted emergency department visits.
Applied survey-weighted logistic regression adjusting for age category, race and ethnicity, and insurance type to evaluate prehospital delay defined by triage acuity.
Female patients had lower odds of delayed presentation compared to males (adjusted odds ratio 0.69, 95% CI 0.51 to 0.93, p = 0.016), with delay observed in approximately 0.31 of females versus 0.40 of males.
Insurance type was significantly associated with delay, with lower odds observed for private insurance (adjusted odds ratio 0.52, 95% CI 0.32 to 0.85, p = 0.009) and other insurance (adjusted odds ratio 0.42, 95% CI 0.26 to 0.69, p < 0.001) compared to Medicaid.
Neither age category (45–64 years: adjusted odds ratio 1.03, 95% CI 0.60 to 1.78, p = 0.907; ≥65 years: adjusted odds ratio 1.29, 95% CI 0.72 to 2.30, p = 0.396) nor race and ethnicity were significantly associated with delayed presentation.

Study Design

Type

Cross-Sectional (n=1,229)

Multicenter

Yes

Structured PICO

Does female sex reduce prehospital delay (approximated by triage acuity) in adults presenting with acute myocardial infarction?

Population

1,229 adult emergency department visits (representing 6.3 million weighted visits) for acute myocardial infarction in the United States, analyzed to assess prehospital delay by sex.

Exposure

Female sex

Comparator

Male sex

Outcome

Prehospital delay, approximated using triage urgency (delayed presentation defined as triage levels 3, 4, or 5 vs early presentation as levels 1 or 2)surrogate

Main Result

Odds Ratio: 0.69 (95% CI 0.51–0.93)

Absolute Event Rate: 31% vs 40%

p-value: p=0.016

In a nationally representative sample of emergency department visits for acute myocardial infarction, female patients had significantly lower odds of delayed presentation (based on triage acuity) compared to males.

Limitations

Cross-sectional nature limits the ability to assess temporal relationships
Outcome was derived from triage acuity and does not directly measure the interval between symptom onset and hospital arrival
Relies on administrative and survey data, which may include measurement error and limited clinical detail
Residual confounding may remain due to unavailable variables such as symptom characteristics, infarction subtype, socioeconomic factors, and mode of transportation
Substantial missingness for mode of arrival led to its exclusion from the models
Outcome derived from triage acuity and does not directly measure the interval between symptom onset and hospital arrival
Relies on administrative and survey data which may include measurement error
Residual confounding due to unavailable variables such as symptom characteristics, infarction subtype, socioeconomic factors, and mode of transportation

Discussion

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Implication

Females less likely to delay presentation; extends evidence on sex differences in acute care-seeking timing.

Cite This Study

Odoeke et al. (2026) conducted a cross-sectional in Acute Myocardial Infarction (n=1,229). Female sex vs. Male sex was evaluated on Delayed presentation (triage levels 3, 4, or 5) (OR 0.69, 95% CI 0.51 to 0.93, p=0.016). Female patients with acute myocardial infarction had significantly lower odds of delayed presentation to the emergency department compared to male patients (adjusted OR 0.69).

synapsesocial.com/papers/6a3d91bf408ebb922448b165 https://doi.org/10.7759/cureus.111424

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Association Between Sex and Prehospital Delay in Patients With Acute Myocardial Infarction: A Cross-Sectional Analysis of the National Hospital Ambulatory Medical Care Survey, 2006-2020

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Association Between Sex and Prehospital Delay in Patients With Acute Myocardial Infarction: A Cross-Sectional Analysis of the National Hospital Ambulatory Medical Care Survey, 2006-2020

Key Points

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider