Factors associated with prehospital delay in ST-elevation myocardial infarction in a tertiary hospital in Nepal.
- c2021.
- ix,39p.
Thesis Report.
SUMMARY:
Cardiovascular diseases are the main cause of morbidity and mortality around the world, accounting for 31% of all deaths. Several studies have found that the total tissue ischemic time, which includes pre-hospital and/or in-hospital delays, has a significant impact on the morbidity and mortality of patients with ST-elevation myocardial infarction (STEMI). Here, we performed our research to find out what factors affect the time it takes for patients with STEMI to arrive at the hospital. This study was conducted over one year period of time from November 2020 to November 2021 in Manmohan Cardiothoracic Vascular and Transplant Centre located in Kathmandu district. The Institutional Review Committee of the hospital approved the study protocol. Univariate and multivariate analyses were performed using the data obtained using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, version 21.0, IBM Corp., Armonk, NY). Of the 235 patients with a diagnosis of Myocardial Infarction (MI) only 71 fit the inclusion criteria. The mean age group of the population studied was 60.62±11.60 (40-86) which consisted of 70.4% male. Only 28.2% of the patients presented to the hospital prior to 2 hours. The mean duration of pre-hospital delay was 5.5 hours. On multivariate analysis, gender (95%CI: 0.300-2.962; p=0.92), age>60 years (95%CI: 0.378-3.570; p=0.79) and symptoms perceived by patients (95%CI: 0.228-2.965; p=0.82) weren’t significantly associated with prehospital delay Extension of thrombolytic therapy to district hospitals and primary health centers after basic medical officer training and collaboration in the form of tele medicine with referral cardiac centers may have a significant impact on morbidity and mortality reduction in acute STEMI patients treated with early reperfusion therapy.