Causes of in-hospital delay for door-to-needle times in patients presenting with acute ST-Elevation Myocardial Infarct in Rural Malaysia

Study Objective: Background: In developing countries such as Malaysia, the primary mode for revascularization is via thrombolytic therapy. The Malaysian Clinical Practice Guideline on acute ST-elevation myocardial infarction advised the implementation of a 30-minute door-to-needle time. This s...

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Main Authors:	Mohd Shah, Azarisman Shah, Ngow, Harris Abdullah, PA, Melor, Abdul Rani, Mohammed Fauzi, Ab Rahman, Jamalludin, Sapari, S., K, Khairi, S, Noorfaizan, Maskon, Oteh
Format:	Article
Language:	English
Published:	Mosby Inc. 2008
Subjects:	R Medicine (General)
Online Access:	http://irep.iium.edu.my/3696/ http://irep.iium.edu.my/3696/ http://irep.iium.edu.my/3696/1/science_%283%29.pdf

id	iium-3696
recordtype	eprints
spelling	iium-36962016-03-10T04:02:58Z http://irep.iium.edu.my/3696/ Causes of in-hospital delay for door-to-needle times in patients presenting with acute ST-Elevation Myocardial Infarct in Rural Malaysia Mohd Shah, Azarisman Shah Ngow, Harris Abdullah PA, Melor Abdul Rani, Mohammed Fauzi Ab Rahman, Jamalludin Sapari, S. K, Khairi S, Noorfaizan Maskon, Oteh R Medicine (General) Study Objective: Background: In developing countries such as Malaysia, the primary mode for revascularization is via thrombolytic therapy. The Malaysian Clinical Practice Guideline on acute ST-elevation myocardial infarction advised the implementation of a 30-minute door-to-needle time. This study aims to evaluate the mean door-to-needle times and the reasons for in-hospital delays. Methods: Ninety four patients with acute ST elevation myocardial infarction patients were screened and 75 patients were recruited in this prospective observational study. The mean door-to-needle times were recorded and the reasons for delays in door-to-needle times were elucidated. Results: The majority of patients were male (89.3%), of Malay ethnicity (84%), presenting with anterior MI (69.3%) with a mean age of 57.0 � 9.52 years. The mean door-to-needle time was 80.54 � 84.8 minutes. Only 20% achieved the 30- minute door-to-needle time and only 65.3% achieved the 60 minute door-to-needle time. The reasons for late thrombolysis were quoted as late referrals from A�E (50%), hypertensive emergency (22%), resuscitation (17%) and others (11%). Conclusion: There is significant in-hospital delay in administrating thrombolytic agents for patients presenting with acute ST-elevation myocardial infarction. Some of the delays were unavoidable (hypertensive emergency and hypotension or VT/VF requiring resuscitation) but the majority of the delay is due to late referrals from A�E to attending cardiology on-call officers. Mosby Inc. 2008-04 Article PeerReviewed application/pdf en http://irep.iium.edu.my/3696/1/science_%283%29.pdf Mohd Shah, Azarisman Shah and Ngow, Harris Abdullah and PA, Melor and Abdul Rani, Mohammed Fauzi and Ab Rahman, Jamalludin and Sapari, S. and K, Khairi and S, Noorfaizan and Maskon, Oteh (2008) Causes of in-hospital delay for door-to-needle times in patients presenting with acute ST-Elevation Myocardial Infarct in Rural Malaysia. Annals of Emergency Medicine, 51 (4). p. 530. ISSN 0196-0644 http://linkinghub.elsevier.com/retrieve/pii/S0196064408002461?showall=true
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Mohd Shah, Azarisman Shah Ngow, Harris Abdullah PA, Melor Abdul Rani, Mohammed Fauzi Ab Rahman, Jamalludin Sapari, S. K, Khairi S, Noorfaizan Maskon, Oteh Causes of in-hospital delay for door-to-needle times in patients presenting with acute ST-Elevation Myocardial Infarct in Rural Malaysia
description	Study Objective: Background: In developing countries such as Malaysia, the primary mode for revascularization is via thrombolytic therapy. The Malaysian Clinical Practice Guideline on acute ST-elevation myocardial infarction advised the implementation of a 30-minute door-to-needle time. This study aims to evaluate the mean door-to-needle times and the reasons for in-hospital delays. Methods: Ninety four patients with acute ST elevation myocardial infarction patients were screened and 75 patients were recruited in this prospective observational study. The mean door-to-needle times were recorded and the reasons for delays in door-to-needle times were elucidated. Results: The majority of patients were male (89.3%), of Malay ethnicity (84%), presenting with anterior MI (69.3%) with a mean age of 57.0 � 9.52 years. The mean door-to-needle time was 80.54 � 84.8 minutes. Only 20% achieved the 30- minute door-to-needle time and only 65.3% achieved the 60 minute door-to-needle time. The reasons for late thrombolysis were quoted as late referrals from A�E (50%), hypertensive emergency (22%), resuscitation (17%) and others (11%). Conclusion: There is significant in-hospital delay in administrating thrombolytic agents for patients presenting with acute ST-elevation myocardial infarction. Some of the delays were unavoidable (hypertensive emergency and hypotension or VT/VF requiring resuscitation) but the majority of the delay is due to late referrals from A�E to attending cardiology on-call officers.
format	Article
author	Mohd Shah, Azarisman Shah Ngow, Harris Abdullah PA, Melor Abdul Rani, Mohammed Fauzi Ab Rahman, Jamalludin Sapari, S. K, Khairi S, Noorfaizan Maskon, Oteh
author_facet	Mohd Shah, Azarisman Shah Ngow, Harris Abdullah PA, Melor Abdul Rani, Mohammed Fauzi Ab Rahman, Jamalludin Sapari, S. K, Khairi S, Noorfaizan Maskon, Oteh
author_sort	Mohd Shah, Azarisman Shah
title	Causes of in-hospital delay for door-to-needle times in patients presenting with acute ST-Elevation Myocardial Infarct in Rural Malaysia
title_short	Causes of in-hospital delay for door-to-needle times in patients presenting with acute ST-Elevation Myocardial Infarct in Rural Malaysia
title_full	Causes of in-hospital delay for door-to-needle times in patients presenting with acute ST-Elevation Myocardial Infarct in Rural Malaysia
title_fullStr	Causes of in-hospital delay for door-to-needle times in patients presenting with acute ST-Elevation Myocardial Infarct in Rural Malaysia
title_full_unstemmed	Causes of in-hospital delay for door-to-needle times in patients presenting with acute ST-Elevation Myocardial Infarct in Rural Malaysia
title_sort	causes of in-hospital delay for door-to-needle times in patients presenting with acute st-elevation myocardial infarct in rural malaysia
publisher	Mosby Inc.
publishDate	2008
url	http://irep.iium.edu.my/3696/ http://irep.iium.edu.my/3696/ http://irep.iium.edu.my/3696/1/science_%283%29.pdf
first_indexed	2023-09-18T20:11:37Z
last_indexed	2023-09-18T20:11:37Z
_version_	1777407515859877888

Causes of in-hospital delay for door-to-needle times in patients presenting with acute ST-Elevation Myocardial Infarct in Rural Malaysia

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