The relationship between socio-demographic characteristics of patients and diagnostic delay in acute pulmonary thromboembolism

• Published in: Upsala journal of medical sciences Vol. 116; no. 1; pp. 72 - 76
• Main Authors: Bulbul, Yilmaz, Ayik, Sibel, Oztuna, Funda, Ozlu, Tevfik, Sahin, Sibel
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01-03-2011; Taylor & Francis; Open Academia
• Subjects: Acute Disease; Adult; Aged; Delay to diagnosis; delay to presentation; Female; Humans; Logistic Models; Male; Middle Aged; Original; Patients; Prospective Studies; pulmonary embolism; Pulmonary Embolism - diagnosis; Pulmonary Embolism - mortality; Pulmonary embolisms; Sociodemographics; Thromboembolism; Time Factors
• ISSN: 0300-9734; 2000-1967
• DOI: 10.3109/03009734.2010.530701

Abstract
Background. In pulmonary thromboembolism (PE), delay to diagnosis is very common. In this study, we examined the role of patients and the socio-demographic characteristics in delayed diagnosis of PE.
Patients and methods. We evaluated 156 PE patients for the dates of symptom onset, the dates of first visit to a health institution and diagnosis, signs and symptoms, and the socio-demographic characteristics. Delays were analyzed using the Mann-Whitney U test, and the predictors were analyzed using logistic regression analysis.
Results. Of the patients, 60.3% visited a health institution within the first day of the symptoms. Mean time from symptoms to the first admission to a health institution (patient delay) was 2.04 ± 3.89 days (median 0 day, range 0-30). Current smoking, a high level of education, and co-morbidity were associated with longer patient delays. The time interval from first symptom to the diagnosis (total delay) was 7.93 ± 10.05 (median 4 days, range 0-45) days. While hypotension, syncope, and previous surgery/trauma were significantly associated with a shorter total delay, a previous visit to any health institution was associated with longer total delay.
Conclusion. In conclusion, although some socio-demographic characteristics of patients such as smoking, educational status, and co-morbid diseases were found to be associated with delayed visit to any health institution, our results showed that physician or health system delays were more prominent in delayed diagnosis of PE.