ArticleThe Lancet regional health. Southeast Asia2023
Prevalence and determinants of delays in care among premature deaths due to acute cardiac conditions and stroke in residents of a district in India.
Article in The Lancet regional health. Southeast Asia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Health-seeking behavior and its determinants for non-communicable diseases in India - a systematic review and meta-analysis.Frontiers in public health · 2025Pooled it
- Systematic review of cardiovascular care delivery across health systems in the Asia-Pacific: a regional roadmap for strengthening cardiovascular care.The Lancet regional health. Western Pacific · 2026Article
- Authorized surrogate presence and its association with early in-hospital delays and outcomes in acute ischemic stroke.International journal of emergency medicine · 2026Article
- Temporal trends of atrial fibrillation and atrial flutter burden across the BRICS: An observational study analysis for the GBD 2021.Medicine · 2026Observational
- Sudden cardiac arrest in young adults: A comprehensive systematic review of epidemiology, aetiology and preventive strategies.Heart international · 2026Review
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- Tackling Cardiovascular Care Deserts in Romania: Expanding Population Access in Underserved Areas.Healthcare (Basel, Switzerland) · 2024Article
- Regional Disparities in Hyperacute Treatment and Functional Outcomes after Acute Ischemic Stroke in Japan.Journal of atherosclerosis and thrombosis · 2024Article
- Observational studies: practical tips for avoiding common statistical pitfalls.The Lancet regional health. Southeast Asia · 2024Review
- Shortening delays in seeking aid for cardiovascular events: a step beyond.The Lancet regional health. Southeast Asia · 2024Article
- Critical role of accompanying authorized surrogates among the multifactorial determinants of in-hospital delays in patients with acute stroke.Frontiers in neurologyArticle
- Strengthening cardiac services in Faridabad District: A facility mapping exercise to explore implementation of a hub-and-spoke model.The Indian journal of medical researchArticle
- Predictors of Pre-hospital Delay in Myocardial Infarction: A Cross-sectional Study at a Tertiary Care Center of Ahmedabad, India.Indian journal of community medicine : official publication of Indian Association of Preventive & Social MedicineArticle
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Lack of timely care is a predictor of poor outcomes in acute cardiovascular emergencies including stroke. We assessed the presence of delay in seeking appropriate care among those who died due to cardiac/stroke emergencies in a community in northern India and identified the reasons and determinants of this delay. Methods: We conducted a social audit among all civil-registered premature (30-69 years) deaths due to acute cardiac event or stroke in the district. The three-delays model was used to qualitatively classify the delays in care-seeking-deciding to seek care, reaching the appropriate health facility (AHF) and initiating definitive treatment. Based on the estimated time from symptom onset to reaching AHF, we classified patients as early (reached within one hour) or delayed arrivers. We used mixed-effect logistic regression with postal code as a random effect to identify determinants of delayed arrival. Findings: Only 10.8% of the deceased reached an AHF within one hour. We noted level-1 delay in 38.4% (60% due to non-recognition of seriousness); level-2 delay in 20% (40% due to going to an inappropriate facility) and level-3 delay in 10.8% (57% due to lack of affordability). Patients with a monthly family income of >270US$ (aOR 0.44; 95% CI 0.21-0.93) were less and those staying farther from AHF (aOR 1.12; 95% CI 1.01-1.25 for each Km) were more likely to have delayed arrival in AHF. Interpretation: A small proportion of patients with cardiac and stroke emergencies reach health facility early with delays at multiple levels. Addressing the reasons for delay could prevent these deaths. Funding: : Indian Council of Medical Research, New Delhi, India.
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