Management quality indicators and inhospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study
Dublin Core
Title
Management quality indicators and inhospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study
Subject
Acute coronary syndrome, Myocardial infarction, Management quality indicators, Mortality, Sub-Saharan
Africa
Africa
Description
Background: Acute coronary syndrome (ACS) remains the leading cause of cardiovascular disease mortality and
morbidity worldwide. While the management quality measures and clinical outcomes of patients with ACS have
been evaluated widely in developed countries, inadequate data are available from sub-Saharan Africa countries. So,
this study aimed to assess the clinical profiles, management quality indicators, and in-hospital outcomes of patients
with ACS in Ethiopia.
Methods: A Prospective observational study was conducted at two tertiary hospitals in Ethiopia from March 2018
to November 2018. The primary outcome of the study was in-hospital mortality. Data were analyzed using SPSS
version 23.0. Multivariable cox-regression was conducted to identify predictors of time to in-hospital mortality.
Variable with p -value < 0.05 was considered statistically significant.
Results: Among 181 ACS patients enrolled, about (61%) were presented with ST-elevation myocardial infarction
(STEMI). The mean age of the study participant was 55.8 ± 11.9 years and 62.4% were males. The use of guidelinedirected medications within 24 h of hospitalization were sub-optimal (57%) [Dual antiplatelet (73%), statin (74%),
beta-blocker (67%) and ACEI (61%)]. Only (7%) ACS patients received the percutaneous coronary intervention (PCI).
Discharge aspirin and statin were high (> 90%) while other medications were sub-optimal (< 80%). The all-cause inhospital mortality rate was 20.4% and the non-fatal MACE rate was 25%. Rural residence (AHR: 3.64, 95% CI: 1.81–
7.29), symptom onset to hospital arrival > 12 h (AHR: 4.23, 95% CI: 1.28–13.81), and Cardiogenic shock (AHR: 7.20,
95% CI: 3.55–14.55) were independent predictors of time to in-hospital death among ACS patients.
Conclusion: In the present study, the use of guideline-directed in-hospital medications was sub-optimal.
The overall in-hospital mortality rate was unacceptably high and highlights the urgent need for national qualityimprovement focusing on timely initiation of evidence-based medications, reperfusion therapy, and strategies to
reduce pre-hospital delay.
morbidity worldwide. While the management quality measures and clinical outcomes of patients with ACS have
been evaluated widely in developed countries, inadequate data are available from sub-Saharan Africa countries. So,
this study aimed to assess the clinical profiles, management quality indicators, and in-hospital outcomes of patients
with ACS in Ethiopia.
Methods: A Prospective observational study was conducted at two tertiary hospitals in Ethiopia from March 2018
to November 2018. The primary outcome of the study was in-hospital mortality. Data were analyzed using SPSS
version 23.0. Multivariable cox-regression was conducted to identify predictors of time to in-hospital mortality.
Variable with p -value < 0.05 was considered statistically significant.
Results: Among 181 ACS patients enrolled, about (61%) were presented with ST-elevation myocardial infarction
(STEMI). The mean age of the study participant was 55.8 ± 11.9 years and 62.4% were males. The use of guidelinedirected medications within 24 h of hospitalization were sub-optimal (57%) [Dual antiplatelet (73%), statin (74%),
beta-blocker (67%) and ACEI (61%)]. Only (7%) ACS patients received the percutaneous coronary intervention (PCI).
Discharge aspirin and statin were high (> 90%) while other medications were sub-optimal (< 80%). The all-cause inhospital mortality rate was 20.4% and the non-fatal MACE rate was 25%. Rural residence (AHR: 3.64, 95% CI: 1.81–
7.29), symptom onset to hospital arrival > 12 h (AHR: 4.23, 95% CI: 1.28–13.81), and Cardiogenic shock (AHR: 7.20,
95% CI: 3.55–14.55) were independent predictors of time to in-hospital death among ACS patients.
Conclusion: In the present study, the use of guideline-directed in-hospital medications was sub-optimal.
The overall in-hospital mortality rate was unacceptably high and highlights the urgent need for national qualityimprovement focusing on timely initiation of evidence-based medications, reperfusion therapy, and strategies to
reduce pre-hospital delay.
Creator
Korinan Fanta, Fekede Bekele Daba, Elsah Tegene, Tsegaye Melaku, Ginenus Fekadu and Legese Chelkeba
Publisher
BMC Emergency Medicine
Date
(2021) 21:41
Contributor
Fajar bagus W
Format
PDF
Language
Indonesia
Type
Text
Files
Collection
Citation
Korinan Fanta, Fekede Bekele Daba, Elsah Tegene, Tsegaye Melaku, Ginenus Fekadu and Legese Chelkeba, “Management quality indicators and inhospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study,” Repository Horizon University Indonesia, accessed September 20, 2024, https://repository.horizon.ac.id/items/show/3776.