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

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...

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Main Authors:	SMS, Azarisman, Ngow, Harris Abdullah, PA, Melor, Ab Rahman, Jamalludin, Ahmad, Fauzi@Fauri, S., Sapari, K., Khairi, S., Noorfaizan, Oteh, Maskon
Format:	Article
Language:	English
Published:	Springer New York LLC 2008
Subjects:	RC Internal medicine
Online Access:	http://irep.iium.edu.my/5251/ http://irep.iium.edu.my/5251/ http://irep.iium.edu.my/5251/1/Combined_Circulation_Abstracts%5B1%5D.pdf

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recordtype	eprints
spelling	iium-52512016-03-10T04:02:14Z http://irep.iium.edu.my/5251/ Implementation of emergency-based thrombolysis : an achievable option for rural hospitals in developing countries SMS, Azarisman Ngow, Harris Abdullah PA, Melor Ab Rahman, Jamalludin Ahmad, Fauzi@Fauri S., Sapari K., Khairi S., Noorfaizan Oteh, Maskon RC Internal medicine 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. Springer New York LLC 2008-05-13 Article NonPeerReviewed application/pdf en http://irep.iium.edu.my/5251/1/Combined_Circulation_Abstracts%5B1%5D.pdf 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 http://apps.webofknowledge.com/full_record.do?product=WOS&search_mode=GeneralSearch&qid=4&SID=T2ADnb8FamD8DhD@H8j&page=1&doc=1
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RC Internal medicine
spellingShingle	RC Internal medicine SMS, Azarisman Ngow, Harris Abdullah PA, Melor Ab Rahman, Jamalludin Ahmad, Fauzi@Fauri S., Sapari K., Khairi S., Noorfaizan Oteh, Maskon Implementation of emergency-based thrombolysis : an achievable option for rural hospitals in developing countries
description	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.
format	Article
author	SMS, Azarisman Ngow, Harris Abdullah PA, Melor Ab Rahman, Jamalludin Ahmad, Fauzi@Fauri S., Sapari K., Khairi S., Noorfaizan Oteh, Maskon
author_facet	SMS, Azarisman Ngow, Harris Abdullah PA, Melor Ab Rahman, Jamalludin Ahmad, Fauzi@Fauri S., Sapari K., Khairi S., Noorfaizan Oteh, Maskon
author_sort	SMS, Azarisman
title	Implementation of emergency-based thrombolysis : an achievable option for rural hospitals in developing countries
title_short	Implementation of emergency-based thrombolysis : an achievable option for rural hospitals in developing countries
title_full	Implementation of emergency-based thrombolysis : an achievable option for rural hospitals in developing countries
title_fullStr	Implementation of emergency-based thrombolysis : an achievable option for rural hospitals in developing countries
title_full_unstemmed	Implementation of emergency-based thrombolysis : an achievable option for rural hospitals in developing countries
title_sort	implementation of emergency-based thrombolysis : an achievable option for rural hospitals in developing countries
publisher	Springer New York LLC
publishDate	2008
url	http://irep.iium.edu.my/5251/ http://irep.iium.edu.my/5251/ http://irep.iium.edu.my/5251/1/Combined_Circulation_Abstracts%5B1%5D.pdf
first_indexed	2023-09-18T20:13:45Z
last_indexed	2023-09-18T20:13:45Z
_version_	1777407649901445120

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

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