In hospital Mortality and correlates among patients admitted for Acute Coronary Syndrome in South India
Journal Title: Medpulse International Journal of Medicine - Year 2018, Vol 8, Issue 3
Abstract
Context: Acute Coronary Syndromes (ACS) is one of the most common causes of a visit to the emergency department among adults. Majority of the Acute Coronary Syndromes are managed in Govt facilities. However, studies on the outcome of ACS among patients treated in these settings are rare. Hence, this study was planned to estimate in-hospital mortality and to identify the factors associated with death among patients admitted in a tertiary teaching institute in South India. Methods: This study was conducted among consecutive patients admitted in the emergency dept with acute coronary syndrome during July-November 2017. All eligible adults more than 30 years were included in the study. After the administrative approval, data on patient characteristics, risk factors, laboratory investigations and therapy measures were extracted through structured proforma. Time to reach hospital after the onset of pain, time to thrombolysis and in-hospital all-cause mortality was considered to be the outcome measures. Results: Total of 100 patients were enrolled in the study where the majority of them were males (78%). Mean (SD) age of presentation with ACS was 57.2 (12.4) years. Median hour of presentation from the onset of chest pain to attending emergency OPD was 5 (3-7) Hours. The average median (Inter Quartile range) time delay between the onset of pain and thrombolysis was 5.6 (3.5-8.5) Hours which included 1.5 hours of delay after reaching the hospital. The median duration of hospital stay was 5 (3-6) days. The death rate among patients admitted and treated for ACS was 21 %( 13.4-30.2%). After the adjusted analysis factors namely diabetes mellitus [adjusted RR (95% CI): 4.6 (1.3-1.7)], need for inotropic support [adjusted RR (95% CI): 5.0 (1.4-1.8)] and advanced Killip grading [adjusted RR (95% CI): 2.1 (1.6-7.0)] were found to be independent predictors of in-hospital ACS mortality. Conclusions: More than 30% of ACS patients did not reach the treating facility within the golden period of six hours. In-hospital mortality was very high(21%) and factors such as diabetes, increased severity of diseases at the time of presentation are independently increased the risk of all-cause mortality among these patients.
Authors and Affiliations
Vinoth Khanna, Priya Anbarasan, Abhinaya Shanmugasundaram
Keywords
Related Articles
- EP ID EP463760
- DOI 10.26611/1021831
- Views 42
- Downloads 0
Neurotoxic manifestations of a Viperine bite - A case report
Snakebite is one of the common life-threatening medical emergencies encountered in Indian population particularly in rural and farming areas. South Asia is the world’s most affected region by snakebite, due to its high p...
Zink phosphide/Rattol poisoning at rural Konkan region
Background: Zinc phosphide is used as a rodenticide and is available as paste, bait pellets, granules, dust, and tracking powder formulations. In Kerala state zinc phosphide has second highest incidence for intoxicant po...
A study of clinical profile and factors associated with diabetic ketoacidosis at tertiary health care center
Background: Diabetic ketoacidosis is an acute metabolic complication of diabetes characterized by the triad of hyperglycemia, acidosis, and ketosis that take place in the presence of very low levels of effective insulin...
A study of prevalence of hyperlipidaemia metabolic syndrome and IHD among hypertensive patients at tertiary health care centre
Background: Metabolic syndrome can be described as a clustering of multiple risk factors that include obesity, physical inactivity and genetic factors Aims and Objectives: To study of prevalence of hyperlipidaemia metabo...
Safety and efficacy of intralesional MMR vaccine along with oral zinc in cutaneous warts
Background: Warts are one of the most common viral infections of humans in which the most frequently used modalities of treatment involve destruction of the affected area, which does not prevent recurrences and often res...