Use of Emergency Medical Services in the Second Gulf Registry of Acute Coronary Events

AlHabib, Khalid F.; AlFaleh, Hussam; Hersi, Ahmad; Kashour, Tarek; Alsheikh‐Ali, Alawi A.; Suwaidi, Jassim Al; Sulaiman, Kadhim; Saif, Shukri Al; Almahmeed, Wael; Asaad, Nidal; Amin, Haitham; Al-Motarreb, Ahmed; Thalib, Lukman

doi:10.1177/0003319713502846

Cited by 16 publications

(25 citation statements)

References 28 publications

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“…It is important to promote the use of EMS, particularly for ACS, among the general public, especially given recent findings indicating an underuse of EMS among ACS patients in the Arabian Gulf region 24,25. Other findings made in this study with respect to specific trends of EMS use may be relevant in the promotion of EMS.…”

Section: Discussionmentioning

confidence: 55%

Outcomes by Mode of Transport of ST Elevation MI Patients in the United Arab Emirates

Callachan

Alsheikh‐Ali

Nair

et al. 2017

WestJEM

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IntroductionThe purpose of this multicenter study was to assess differences in demographics, medical history, treatment times, and follow-up status among patients with ST-elevation myocardial infarction (STEMI), who were transported to the hospital by emergency medical services (EMS) or by private vehicle, or were transferred from other medical facilities.MethodsThis multicenter study involved the collection of both retrospective and prospective data from 455 patients admitted to four hospitals in Abu Dhabi. We collected electronic medical records from EMS and hospitals, and conducted interviews with patients in person or via telephone. Chi-square tests and Kruskal–Wallis tests were used to examine differences in variables by mode of transportation.ResultsResults indicated significant differences in modes of transportation when considering symptom-onset-to-balloon time (p < 0.001), door-to-balloon time (p < 0.001), and health status at six-month and one-year follow-up (p < 0.001). Median times (interquartile range) for patients transported by EMS, private vehicle, or transferred from an outside facility were as follows: symptom-onset-to-balloon time in hours, 3.1 (1.8–4.3), 3.2 (2.1–5.3), and 4.5 (3.0–7.5), respectively; door-to-balloon time in minutes, 70 (48–78), 81 (64–105), and 62 (46–77), respectively. In all cases, EMS transportation was associated with a shorter time to treatment than other modes of transportation. However, the EMS group experienced greater rates of in-hospital events, including cardiac arrest and mortality, than the private transport group.ConclusionOur results contribute data supporting EMS transportation for patients with acute coronary syndrome. Although a lack of follow-up data made it difficult to draw conclusions about long-term outcomes, our findings clearly indicate that EMS transportation can speed time to treatment, including time to balloon inflation, potentially reducing readmission and adverse events. We conclude that future efforts should focus on encouraging the use of EMS and improving transfer practices. Such efforts could improve outcomes for patients presenting with STEMI.

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Section: Discussionmentioning

confidence: 55%

Outcomes by Mode of Transport of ST Elevation MI Patients in the United Arab Emirates

Callachan

Alsheikh‐Ali

Nair

et al. 2017

WestJEM

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“…The shortage of skilled manpower is exaggerated during holiday seasons when even PCI-capable hospitals would not have enough staff to carry out primary PCI round the clock. The underuse of emergency medical services was observed in several of our previous local registries where less than 17% of ACS patients use ambulance services to get to the hospital [23,24]. This results in most patients presenting first to non-PCI-capable hospitals.…”

Section: Strength and Implicationsmentioning

confidence: 99%

Efficacy and Safety of Pharmacoinvasive Strategy Compared to Primary Percutaneous Coronary Intervention in the Management of ST-Segment Elevation Myocardial Infarction: A Prospective Country-Wide Registry

Zubaid

Khraishah

Alahmad

et al. 2020

Annals of Global Health

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Background: A pharmacoinvasive reperfusion strategy is recommended for ST-elevation myocardial infarction (STEMI) patients when primary percutaneous coronary intervention (PCI) cannot be achieved in a timely fashion. This is based on a limited number of trials. The effectiveness of this strategy in the realworld is unclear. Objectives: To compare the effectiveness of pharmacoinvasive strategy versus primary PCI using a nationwide prospective registry of STEMI patients. Methods: We examined 936 STEMI patients from the reperfusion in ST-elevation myocardial infarction in Kuwait (REPERFUSE Kuwait) registry who underwent either primary PCI or pharmacoinvasive reperfusion. A composite outcome was measured based on death, congestive heart failure, reinfarction or stroke prospectively ascertained during hospital stay and up to one-year follow-up. The association between reperfusion strategy and the composite outcome was assessed using multivariate regression and Poisson proportional hazard model. Results: Compared to the pharmacoinvasive group, those undergoing primary PCI had higher Killip class on presentation and required more blood transfusions during hospitalization. There was no significant difference between primary PCI and pharmacoinvasive strategy with regards to the incidence of the composite outcome during the in-hospital period (RR = 1.0; 95% CI 0.98-1.02; p = 0.96) after adjustment for possible confounders. Over one-year follow-up, the survival of the two groups was not different (p = 0.66). The incidence of major bleeding was similar in both groups. Conclusion: STEMI patients treated with a pharmacoinvasive strategy have comparable outcomes to those treated with primary PCI with no increased risk of major bleeding. These real-world data support the use of a pharmacoinvasive strategy when primary PCI cannot be achieved in a timely fashion.

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“…Pasien mengalami kesulitan untuk pergi ke rumah sakit. Selain itu juga dengan meminjam atau menunggu saudara yang lain membawa kendaraan akan memperlama waktu tiba di IGD (Fares, 2011;Alhabib et al, 2014). Penyebab lain dari waktu keterlambatan pasien SKA di IGD RSUD dr. TC.Hillers Maumere adalah karena belum tersedianya layanan gawat darurat medis, mayoritas pasien SKA di bawah ke rumah sakit dengan kendaraan umum, akibatnya terjadinya waktu keterlambatan yang semakin memanjang.…”

Section: Hubungan Jenis Transportasi Dengan Waktu Keterlambatan Penanunclassified

THE CORRELATION OF HEALTH SEEKING BEHAVIOR AND TRANSPORTATION MODE WITH PREHOSPITAL DELAY TIME IN PATIENTS WITH ACUTE CORONARY SYNDROME AT EMERGENCY DEPARTMENT OF REGIONAL PUBLIC HOSPITAL OF dr. T.C. HILLERS

Irman¹,

Poeranto²,

Suharsono³

2017

NLJ

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ABSTRAKKondisi kegawatdaruratan sindrom koroner akut (SKA) memerlukan penatalaksanaan yang cepat dan tepat. Keterlambatan respon waktu yang panjang sebelum ke rumah sakit dapat berakibat kematian yang dikaitkan dengan perilaku pencarian pelayanan kesehatan dan jenis transportasi. Tujuan penelitian ini untuk menganalisis hubungan perilaku pencarian pelayanan kesehatan dan jenis transportasi dengan waktu keterlambatan penanganan sebelum masuk ke rumah sakit pasien SKA di IGD RSUD dr. TC. Hillers Maumere. Jenis penelitian observasional analitik dengan pendekatan cross sectional. Tehnik yang digunakan adalah consecutive sampling dengan besar sampel sebanyak 42 partisipan. Data dikumpulkan dengan lembar wawancara pada bulan April-Juni 2017, kemudian di analisis secara univariat dan bivariat (uji Fisher). Hasil penelitian menunjukkan mayoritas perilaku pencarian pelayanan kesehatan pasien SKA adalah menunda ke rumah sakit (76,2%) dan jenis transportasi yang digunakan adalah kendaraan umum (31%). Waktu keterlambatan penanganan sebelum masuk ke rumah sakit terbanyak yaitu tiba terlambat (>120 menit) (61,9%). Hasil uji Fisher menunjukkan ada hubungan perilaku pencarian pelayanan kesehatan dan jenis transportasi dengan waktu keterlambatan penanganan sebelum masuk ke rumah sakit pasien SKA di IGD RSUD dr. TC. Hillers Maumere. Hasil penelitian mengindikasikan pentingnya memperbaiki sistem rujukan pasien, pemberian pendidikan kesehatan untuk memperbaiki perilaku pencarian pelayanan kesehatan, menyediakan ambulan desa, mendukung dan membentuk layanan gawat darurat medis. ABSTRACT Emergency conditions of the acute coronary syndrome (ACS

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Use of Emergency Medical Services in the Second Gulf Registry of Acute Coronary Events

Cited by 16 publications

References 28 publications

Outcomes by Mode of Transport of ST Elevation MI Patients in the United Arab Emirates

Outcomes by Mode of Transport of ST Elevation MI Patients in the United Arab Emirates

Efficacy and Safety of Pharmacoinvasive Strategy Compared to Primary Percutaneous Coronary Intervention in the Management of ST-Segment Elevation Myocardial Infarction: A Prospective Country-Wide Registry

THE CORRELATION OF HEALTH SEEKING BEHAVIOR AND TRANSPORTATION MODE WITH PREHOSPITAL DELAY TIME IN PATIENTS WITH ACUTE CORONARY SYNDROME AT EMERGENCY DEPARTMENT OF REGIONAL PUBLIC HOSPITAL OF dr. T.C. HILLERS

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