Research Article
Management Delays and Outcomes in ST-Elevation Myocardial Infarction (STEMI) in the COVID-19 Era in Senegal: Insights from a Tertiary Center
Ngone Diaba Gaye*
,
Aliou Alassane Ngaide,
Joseph Salvador Mingou,
Ameth Ngningue,
Mouhamadou Bamba Ndiaye,
Alassane Mbaye,
Abdoul Kane
Issue:
Volume 10, Issue 3, June 2024
Pages:
29-35
Received:
19 July 2024
Accepted:
20 August 2024
Published:
11 September 2024
Abstract: Low-and middle-income countries (LMICs) face many challenges regarding the timely management of STEMI, and the COVID-19 pandemic has impacted our already fragile health systems. The aim of this study was to assess the delays in managing STEMI during COVID-19 and evaluate the 6-month mortality rates related to these delays. A retrospective cross-sectional study was conducted over two years starting from January 2020 at a tertiary center in Dakar, Senegal. All patients referred for STEMI during the study period were included. Statistical analysis was performed using R, version 4.4.0 (R Foundation for Statistical Computing). A total of 273 patients were enrolled during the study period (65.9% males, mean age: 59 ± 12.4). Diabetes Mellitus was present in 37.7% of cases. Only 1 out of 5 patients (20.5%) reached medical attention within 1 hour after symptoms onset, and the time from first medical contact to ECG was < 10 minutes in 39 % of cases. Primary PCI within the first 24 hours was performed in 23.5% of cases. Factors significantly associated with late hospital admission (<12h) were first medical contact < 1h (P 0.0009, OR: 4.06 95% CI; 1.8-9.64), time to first ECG < 10 minutes (P 0.002, OR: 2.79 95% CI; 1.45-5.41) and number of facilities visited < 2 (P 0.004, OR: 3.4 95% CI 1.51-8.22). The 6-month mortality rate was 18.7%, and the probability of death increased with a more significant delay in first medical contact. Our study found persisting delays in STEMI management in Senegal. Establishing a standard of care for STEMI in Senegal is mandatory to overcome healthcare system weaknesses and improve the outcomes of our STEMI patients.
Abstract: Low-and middle-income countries (LMICs) face many challenges regarding the timely management of STEMI, and the COVID-19 pandemic has impacted our already fragile health systems. The aim of this study was to assess the delays in managing STEMI during COVID-19 and evaluate the 6-month mortality rates related to these delays. A retrospective cross-sec...
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Research Article
Evaluating Pericardiectomy Outcomes and Determinants; an 8-Year Retrospective Study at Tertiary Teaching Hospitals in Ethiopia
Mekonnen F. Senbu*,
Admikew Bekele Desalegn,
Demu Tesfaye Mideksa
Issue:
Volume 10, Issue 3, June 2024
Pages:
36-45
Received:
31 May 2024
Accepted:
3 September 2024
Published:
26 September 2024
Abstract: Background: Constrictive pericarditis has a variety of etiologies which leads to severe symptoms and heart failure which affects the quality of life. So far the main modality of treatment is pericardiectomy. Objective: The aim of this research was to know pericardiectomy outcomes and determinants among constrictive pericarditis patients who were operated at Tikur Anbessa Specialized Hospital from 2014 - 2022. Methods: A retrospective study was done among 65 patients. Data was presented using frequencies with percentages, mean (±standard deviation) and/ or median (interquartile range) as required. Perioperative mortality and complications were summarized using incidence density with 95% confidence interval (CI). Result: Most patients were in their 20s (53.8%) and where male are (84.6%). The commonest presenting symptom was shortness of breath (100%), fatiguability (96.9%), and coughs (66.2%). The median time of presentation was 12.3 months (IQR, 7.0-25.5). There were also cases with clinical symptoms of tuberculosis (13.8%). The etiology of constrictive pericarditis was infectious in 83.1% of cases. The mean length of surgery was 3.3 ± 0.6 hours. The median duration of hospital stay is 9.0 days (IQR, 7.0-12.0). The incidence rate (IR) of perioperative death was 7.9 per 1000 person-days (PD) of observation (94% CI = 3.3 – 19.2) and the incidence rate of complication was 4.8 per 1000 PD (95% CI = 1.5 -14.9). Conclusion: Pericardiectomy is the best treatment for patients with constrictive pericarditis. The majority of patients had a good outcome, with an improvement in symptoms and functional status. The mortality rate was low, and the complication rate was acceptable. However, this study is based on relatively small sample size, and it is a retrospective study from a single center. Hence, further prospective studies are needed to confirm the findings of this study.
Abstract: Background: Constrictive pericarditis has a variety of etiologies which leads to severe symptoms and heart failure which affects the quality of life. So far the main modality of treatment is pericardiectomy. Objective: The aim of this research was to know pericardiectomy outcomes and determinants among constrictive pericarditis patients who were op...
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