Implementation of emergency-based thrombolysis : an achievable option for rural hospitals in developing countries

SMS, Azarisman and Ngow, Harris Abdullah and PA, Melor and Ab Rahman, Jamalludin and Ahmad, Fauzi@Fauri and S., Sapari and K., Khairi and S., Noorfaizan and Oteh, Maskon (2008) Implementation of emergency-based thrombolysis : an achievable option for rural hospitals in developing countries. Journal of Thrombosis and Thrombolysis : a journal for translation, application and therapeutics, 118 (12). E206-E206. ISSN 0929-5305

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Abstract

Background In developing countries such as Malaysia, the primary mode for revascularization is via thrombolytic therapy. This is only effective when instituted within a small time window and pre-hospital delay is a major concern. In a region where the mean house-to-door times can be as long as 8.5 hours, there is an urgent need to reduce the door-to-needle times. Methods Emergency-based thrombolysis was initiated at Hospital Tengku Ampuan Afzan Kuantan, a 600-bed regional hospital in Malaysia. One hundred and thirty three patients with acute ST elevation myocardial infarction patients were screened. 39 patients were recruited in the 4 months prior to the implementation date and 94 patients were recruited after. The mean house-to-door, door-to-needle times were recorded. Results The majority of patients were male 88.7%, with a mean age of 56.4 � 10.3 years. The median presentation time (house-to-door) was 117.50 minutes before and 136.00 minutes after (p � 0.213, Mann- Whitney U) minutes. The median door-to-needle time was 100.00 minutes before and 50.00 minutes after (p � 0.031). The mortality rates were 12.8% before and 11.70% (p�0.87, Fisher exact test) after mplementation of Emergency-based thrombolysis. Conclusion Implementation of Emergency-based thrombolysis has markedly improved the door-to-needle times and resulted in a trend towards reduced mortality rates in acute ST-elevation myocardial infarction.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Pre-hospital, acute myocardial infarct, ST elevation, door-to-needle time.
Subjects:	R Medicine > RC Internal medicine
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Community Health & Family Medicine Kulliyyah of Medicine > Department of Internal Medicine
Depositing User:	Associate Professor Dr Harris Ngow Abdullah
Date Deposited:	15 Jul 2013 16:01
Last Modified:	10 Mar 2016 12:02
URI:	http://irep.iium.edu.my/id/eprint/5251

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