3.4  Patients' choice of contact for help following onset of acute symptoms
Following symptom onset, 45% of patients initially decided to call the EMS rather than other sources of help such as their physician, family/friends, or to refer themselves directly to hospital. As predicted, patients who contacted the EMS for help were more likely to have short total pre-hospital delays: 74.0% of patients who contacted the EMS had total pre-hospital delays ≤ 120 min compared with 33.0% of those who contacted another source of help (adjusted OR 5.80, C.I. 2.98 to 11.30). Patients who contacted the EMS also had shorter decision times; 80.3% had a decision time ≤ 60 min compared with 45.7% who contacted another source of help (adjusted OR 4.83, C.I. 2.40 to 9.70). Interestingly, contacting the EMS was not related to the home-to-hospital component of the total pre-hospital delay period but only to decision time.
We investigated the correlates of contacting the EMS following symptom onset. It was not related to age, gender, marital status, education, cardiac history, attribution of symptoms, ACS type, or the presence of a bystander. However, patients who contacted the EMS were likely to have more intense chest pain (adjusted OR 2.05, C.I. 1.01 to 4.61, p = 0.047) and more likely to have an ACS at the weekend rather than a weekday (adjusted OR 1.82, C.I. 0.98 to 3.36, p = 0.057) than those who did not.