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Objectives
This study was conducted to evaluate the effect of direct emergency department activation of the catheterization lab on door-to-balloon time (D2BT) and outcomes of acute ST-elevation myocardial infarction (STEMI) patients at a major tertiary care hospital in Riyadh, Saudi Arabia.Methods
This was a retrospective cohort study that enrolled 100 consecutive patients with acute STEMI who underwent primary percutaneous coronary intervention between June 2010 and January 2015. The patients were divided into two groups of 50 patients each. The first group was treated prior to establishing the Code-STEMI protocol. The other group was treated according to the protocol, which was implemented in June 2013. The Code-STEMI protocol is a comprehensive program implementing direct activation of the catheterization lab team using a single call system, data monitoring and feedback, and standardized order forms.Results
The mean age for both groups was 54?±?12?years. Males represented 86% (43) and 94% (47) of the patients in the two groups, respectively. In both groups, 90% (90) of patients had one or more comorbidities. The Code-STEMI group had a significantly lower D2BT, with 70% of patients treated within the recommended 90?minutes (median, 76.5?minutes; interquartile range, 63–90?minutes). By contrast, only 26% of pre-Code-STEMI patients were treated within this timeframe (median, 107?minutes; interquartile range, 74–149?minutes). In-hospital complications were lower in the Code-STEMI group; however, the only statistically significant reduction was in non-fatal re-infarction (8% vs. 0%, p?=?0.043).Conclusion
Implementation of direct emergency department catheterization lab activation protocol was associated with a significant reduction in D2BT. 相似文献Methods: Data were derived from Gulf CARE (Gulf aCute heArt failuRe rEgistry), a prospective multicenter study of 5005 consecutive patients hospitalized with acute HF during February-November 2012 in 7 Middle Eastern countries.
Results: The prevalence of CAD among Acute Heart Failure (AHF) patients was 60.2% and varied significantly among the 7 countries (Qatar 65.7%, UAE 66.6%, Kuwait 68.0%, Oman 65.9%, Saudi Arabia 62.5%, Bahrain 52.7% and Yemen 49.1%) with lower values in the lower income countries. CAD patients were older and more likely to have diabetes, hypertension, dyslipidemia and chronic kidney disease. Moreover, CAD patients were more likely to have history of cerebrovascular and peripheral vascular disease when compared to non-CAD patients. In-hospital mortality rates were comparable although CAD patients had more frequent re-hospitalization and worse long-term outcome. However, CAD was not an independent predictor of poor outcome.
Conclusion: The prevalence of CAD amongst patients with HF in the Middle East is variable and may be related to healthcare sources. Regional and national studies are needed for assessing further the impact of various etiologies of HF and for developing appropriate strategies to combat this global concern. 相似文献
Introduction
In North Africa and the Middle East, studies about dementia prevalence are scarce. A pilot study was conducted in Lebanon to assess dementia prevalence, using the Arabic-validated 10/66 Dementia Research Group (DRG) diagnostic assessment for case ascertainment. The study also examined care arrangement and access to care.Methods
A random sample of 502 persons older than 65 years and their informant were recruited from Beirut and Mount Lebanon governorates through multistage cluster sampling.Results
The crude and age-standardized dementia prevalences were 7.4% and 9.0%, respectively. People with dementia were mainly cared for by relatives at home. Access to formal care was very limited.Discussion
Dementia prevalence in Lebanon ranks high within the global range of estimates. These first evidence-based data about disease burden and barriers to care serve to raise awareness and call for social and health care reform to tackle the dementia epidemic in Lebanon and in North Africa and the Middle East. 相似文献![点击此处可从《Echocardiography (Mount Kisco, N.Y.)》网站下载免费的PDF全文](/ch/ext_images/free.gif)