Key result
Presenting with atypical symptoms of acute coronary syndrome significantly increased the likelihood of delayed access to medical services compared to typical symptoms (AOR 2.67).
Why the study?
Delayed access to services for acute coronary syndrome can worsen outcomes, but factors associated with delayed access in Yala Province, Southern Thailand, needed identification.
Cross-Sectional (n=668)
Yes
Odds Ratio: 2.67 (95% CI 1.81–3.94)
Absolute Event Rate: 63.31% vs 36.47%
p-value: p=<0.001
Lower education level, atypical symptoms, and smaller hospital size are significantly associated with delayed access to care (>180 mins) for ACS patients in rural Southern Thailand.
High incidence of delayed rural ACS care warrants attention to atypical symptoms; leaves open whether targeting hospital size improves access.
Background: Delayed access to services for acute coronary syndrome (ACS) can worsen outcomes. This hospital-based, cross-sectional study aimed to identify factors associated with delayed access to ACS care in Yala Province, Southern Thailand. Methods: The study analyzed ACS patients from community hospitals in Yala Province, enrolled between October 1, 2018, and September 30, 2021, using data from the Yala ACS Registry and HosXp Database. Among 668 patients, 289 experienced delayed access to services, while 379 did not. Descriptive statistics and multiple logistic regression were applied for analysis. Results: The incidence of delayed access to services was 43.26 % (95 %CI: 39.47-47.12). The factors significantlyassociated with delayed access included: education level (graduated from secondary school, AOR = 0.54, 95 %CI:0.36-0.84; p-value = 0.021), having one underlying disease (AOR = 0.54, 95 %CI: 0.34-0.84; p-value = 0.027), moderate to heavy activity intensity (AOR = 0.60, 95 %CI: 0.38-0.97; p-value = 0.036), having atypical symptoms of ACS (AOR = 2.67, 95 %CI: 1.81-3.94; p-value <0.001), and access to hospitals with 30 or 60 beds (AOR = 1.83, 95 %CI: 1.14-2.95; AOR = 3.02, 95 % CI: 2.00-4.60; p-value <0.001). Conclusion: Education level, number of underlying diseases, activity intensity, and hospital size were linked to delayed access to ACS care. Medical professionals should address these factors to enhance awareness of ACS symptoms, encourage early hospital visits, and reduce the risks of cardiac dysfunction, disability, and death. Keywords: Acute coronary syndrome, Delayed onset to services, Thailand The incidence of delayed access to services was 43.26 % (95 %CI: 39.47-47.12). The factors significantly associated with delayed access included: education level (graduated from secondary school, AOR = 0.54, 95 %CI: 0.36-0.84; p-value = 0.021), having one underlying disease (AOR = 0.54, 95 %CI: 0.34-0.84; p-value = 0.027), moderate to heavy activity intensity (AOR = 0.60, 95 %CI: 0.38-0.97; p-value = 0.036), having atypical symptoms of ACS (AOR = 2.67, 95 %CI: 1.81-3.94; p-value <0.001), and access to hospitals with 30 or 60 beds (AOR = 1.83, 95 %CI: 1.14-2.95; AOR = 3.02, 95 % CI: 2.00-4.60; p-value <0.001).
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Arboo et al. (2025) conducted a cross-sectional in Acute Coronary Syndrome (n=668). Atypical symptoms of ACS vs. Typical symptoms of ACS was evaluated on Delayed onset to services (>180 minutes from symptom onset to emergency room care) (AOR 2.67, 95% CI 1.81-3.94, p=<0.001). Presenting with atypical symptoms of acute coronary syndrome significantly increased the likelihood of delayed access to medical services compared to typical symptoms (AOR 2.67).
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