SIGNIFICANCE OF TIME FROM THE ONSET OF PAIN TO ARRIVAL AT THE HOSPITAL AFTER A HEART ATTACK IN THE HERZEGOVINA AREA

Abstract

Introduction: Ischemic heart disease (IHD) is the leading cause of death in the world. It can manifest as
stable and unstable angina pectoris, acute myocardial infarction (AMI), functional heart failure, and
sudden cardiac death. Every year, around 17 million people worldwide die from IHD, including 5 million
people a year in Europe. To assess the effectiveness of the health system, it is important to determine how
much time, from the onset of pain to arrival at the intensive care unit (ICU), depends on the distance of the
patient's residence from Mostar, especially in the remote areas of the Herzegovina Neretva Canton
(HNŽ/K) and West Herzegovina Canton (ZHŽ/K).
Objective: Determine the significance of time from the onset of pain to arrival at the hospital after a heart
attack in the territory of Herzegovina.
Results: The research included a total of 95 patients with AMI, ST-elevation myocardial infarction
(STEMI) and non-ST elevation myocardial infarction (NSTEMI), who were transported in ambulance
vehicles and admitted to the Intensive Care Unit of the University Clinical Hospital Mostar. Patients with
AMI from Mostar and the surrounding area (HNŽ/K<15km) called emergency medical services (EMS)
earlier than patients who live in more distant areas, therefore the transport of these patients to the hospital
was much faster. The time measured from the arrival of the ambulance/family doctor to the arrival at the
hospital showed a significant statistical difference between the two regions of Herzegovina. The
assumption is that people with a higher level of education can recognize symptoms earlier and call a
doctor, which was also statistically significant in this study.
Conclusion: The time from the onset of pain to the hospitalization of patients with acute myocardial
infarction in all three investigated regions is within the expected suggested time, also known as the golden
hour.