1887
2 - International Conference in Emergency Medicine and Public Health-Qatar Proceedings
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

There appear to be variations in the time of presentation patients with ACS around the world. The working days and weekends differ in Qatar from the Western world.

In 1846 patients admitted with ACS, 721 had Primary PCI for STEMI and 1125 had Non-ST Elevation ACS (NSTE-ACS). The days and time of onset of symptoms, Door to Balloon Time (DBT) and Out of Hospital Delay were compared in different time periods in relation to the weekend (Friday/Saturday), and 2-days before (B-WKE), or 2-days after (A-WKE). The intra-day variation was compared in day time (6AM-6PM), and night time (6PM-6AM).

Overall, almost half ACS patients (both STEMI and NSTE-ACS) presented in 2 days After WKE (Sun & Mon), with 60% of these presenting on Sunday alone, compared to only 16% over WKE (Fri & Sat). This was true for males with both STEMI and NSTEMI and for females with NSTE-ACS. However, the pattern was reversed in females with STEMI, 39% presented during week days vs only 19% After WKE (Sun & Mon). For both sexes and all ages, most (58%) presented early day time with modal symptoms starting time around 4 AM. In Primary PCI patients, the DBT was longer (77.5 min) during the night vs (61 min) during day, but in both >90% were within 90 min. 66% of STEMI total occlusion (TIMI-0) during the night. TIMI-3 flow was achieved in 94% during the day vs (87%) at night. Out of Hospital Delay was longer at night (270 min) vs (200 min) during the day. However, in-hospital mortality and LV function was similar.

There are interesting variations diurnal and gender variation in time of presentation of ACS. However, this does not seem to make significant impact on in-hospital outcome in the Primary PCI, perhaps because majority achieved optimal Door to Balloon Time.

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/content/journals/10.5339/jemtac.2016.icepq.129
2016-10-09
2020-10-28
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  • Article Type: Research Article
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