Acute myocardial infarction at a district hospital in KwaZulu-Natal – Management and outcomes
Background: Acute myocardial infarction (AMI) following ischaemic heart disease (IHD) is associated with increased morbidity and mortality. The condition remains a management challenge in resource-constrained environments. This study analysed the management and outcomes of patients presenting with A...
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AOSIS
2022-06-01
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| Series: | South African Family Practice |
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| Online Access: | https://safpj.co.za/index.php/safpj/article/view/5463 |
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| author | Zakariya Badat Selvandran Rangiah |
| author_facet | Zakariya Badat Selvandran Rangiah |
| author_sort | Zakariya Badat |
| collection | DOAJ |
| description | Background: Acute myocardial infarction (AMI) following ischaemic heart disease (IHD) is associated with increased morbidity and mortality. The condition remains a management challenge in resource-constrained environments. This study analysed the management and outcomes of patients presenting with AMI at a district hospital in KwaZulu-Natal.
Methods: A descriptive study that assessed hospital records of all patients diagnosed with AMI over a 2-year period (01 August 2016 to 31 July 2018). Data extracted recorded patient demographics, risk factors, timing of care, therapeutic interventions, follow up with cardiology and mortality of patients.
Results: Of the 140 patients who were admitted with AMI, 96 hospital records were analysed. The mean (standard deviation [s.d.]) age of patients was 55.8 (±12.7) years. Smoking (73.5%) and hypertension (63.3%) were the most prevalent risk factors for patients with ST elevation myocardial infarction (STEMI) in contrast to dyslipidaemia (70.2%) and hypertension (68.1%) in patients with non-ST elevation myocardial infarction (NSTEMI). Almost 49.5% of patients arrived at hospital more than 6 h after symptom onset. Three (12.5%) patients received thrombolytic therapy within the recommended 30-min time frame. The mean triage-to-needle time was 183 min – range (3; 550). Median time to cardiology appointment was 93 days. The in-hospital mortality of 12 deaths considering 140 admissions was 8.6%.
Conclusion: In a resource-constrained environment with multiple systemic challenges, in-hospital mortality is comparable to that in private sector conditions in South Africa. This entrenches the role of the family physician. There is need for more coordinated systems of care for AMI between district hospitals and tertiary referral centres. |
| format | Article |
| id | doaj-art-792bbb657b754cb79e9aacba9cb0124a |
| institution | Kabale University |
| issn | 2078-6190 2078-6204 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Family Practice |
| spelling | doaj-art-792bbb657b754cb79e9aacba9cb0124a2025-08-20T03:47:09ZengAOSISSouth African Family Practice2078-61902078-62042022-06-01641e1e810.4102/safp.v64i1.54634235Acute myocardial infarction at a district hospital in KwaZulu-Natal – Management and outcomesZakariya Badat0Selvandran Rangiah1Department of Family Medicine, College of Health Sciences, University of KwaZulu-Natal, DurbanDepartment of Family Medicine, College of Health Sciences, University of KwaZulu-Natal, DurbanBackground: Acute myocardial infarction (AMI) following ischaemic heart disease (IHD) is associated with increased morbidity and mortality. The condition remains a management challenge in resource-constrained environments. This study analysed the management and outcomes of patients presenting with AMI at a district hospital in KwaZulu-Natal. Methods: A descriptive study that assessed hospital records of all patients diagnosed with AMI over a 2-year period (01 August 2016 to 31 July 2018). Data extracted recorded patient demographics, risk factors, timing of care, therapeutic interventions, follow up with cardiology and mortality of patients. Results: Of the 140 patients who were admitted with AMI, 96 hospital records were analysed. The mean (standard deviation [s.d.]) age of patients was 55.8 (±12.7) years. Smoking (73.5%) and hypertension (63.3%) were the most prevalent risk factors for patients with ST elevation myocardial infarction (STEMI) in contrast to dyslipidaemia (70.2%) and hypertension (68.1%) in patients with non-ST elevation myocardial infarction (NSTEMI). Almost 49.5% of patients arrived at hospital more than 6 h after symptom onset. Three (12.5%) patients received thrombolytic therapy within the recommended 30-min time frame. The mean triage-to-needle time was 183 min – range (3; 550). Median time to cardiology appointment was 93 days. The in-hospital mortality of 12 deaths considering 140 admissions was 8.6%. Conclusion: In a resource-constrained environment with multiple systemic challenges, in-hospital mortality is comparable to that in private sector conditions in South Africa. This entrenches the role of the family physician. There is need for more coordinated systems of care for AMI between district hospitals and tertiary referral centres.https://safpj.co.za/index.php/safpj/article/view/5463acute myocardial infarctionischaemic heart diseasemanagement outcomesdistrict hospitalsteminstemi |
| spellingShingle | Zakariya Badat Selvandran Rangiah Acute myocardial infarction at a district hospital in KwaZulu-Natal – Management and outcomes South African Family Practice acute myocardial infarction ischaemic heart disease management outcomes district hospital stemi nstemi |
| title | Acute myocardial infarction at a district hospital in KwaZulu-Natal – Management and outcomes |
| title_full | Acute myocardial infarction at a district hospital in KwaZulu-Natal – Management and outcomes |
| title_fullStr | Acute myocardial infarction at a district hospital in KwaZulu-Natal – Management and outcomes |
| title_full_unstemmed | Acute myocardial infarction at a district hospital in KwaZulu-Natal – Management and outcomes |
| title_short | Acute myocardial infarction at a district hospital in KwaZulu-Natal – Management and outcomes |
| title_sort | acute myocardial infarction at a district hospital in kwazulu natal management and outcomes |
| topic | acute myocardial infarction ischaemic heart disease management outcomes district hospital stemi nstemi |
| url | https://safpj.co.za/index.php/safpj/article/view/5463 |
| work_keys_str_mv | AT zakariyabadat acutemyocardialinfarctionatadistricthospitalinkwazulunatalmanagementandoutcomes AT selvandranrangiah acutemyocardialinfarctionatadistricthospitalinkwazulunatalmanagementandoutcomes |