scholarly journals No Evidence for Reduced Hospital Admissions or Increased Deaths from Stroke or Heart Attack During COVID-19

2020 ◽  
Author(s):  
Katharine Reeves ◽  
Samuel Watson ◽  
Tanya Pankhurst ◽  
Kamlesh Khunti ◽  
Suzy Gallier ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Attack ◽  
Hospital Admissions ◽  
Ambulance Service ◽  
St Elevation Myocardial Infarction ◽  
University Hospital ◽  
The West ◽  
West Midlands ◽  
St Elevation ◽  
The Uk

Articles in the UK press have claimed that hospital admissions for heart attack and stroke have declined during the COVID-19 pandemic. However, data from the West Midlands Ambulance Service have not shown any reduction in call-outs for patients with stroke or ST-Elevation Myocardial Infarction. This study examined data from University Hospital Birmingham NHS Foundation Trust, comparing admissions from week 1 of 2016 to week 17 of 2019, with the same period in 2020, pre- and post-lockdown. The results showed that there was no evidence of a reduction in the overall mean number of admissions of patients with these conditions in the post-lockdown period.

scholarly journals Development and validation of techniques for phenotyping ST-elevation myocardial infarction encounters from electronic health records

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Sulaiman Somani ◽  
Stephen Yoffie ◽  
Shelly Teng ◽  
Shreyas Havaldar ◽  
Girish N Nadkarni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Electronic Health Records ◽  
Hospital Admissions ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Health Records ◽  
St Elevation ◽  
Electronic Health ◽  
Cardiac Catheterizations ◽  
Discharge Summaries

Abstract Objectives Classifying hospital admissions into various acute myocardial infarction phenotypes in electronic health records (EHRs) is a challenging task with strong research implications that remains unsolved. To our knowledge, this study is the first study to design and validate phenotyping algorithms using cardiac catheterizations to identify not only patients with a ST-elevation myocardial infarction (STEMI), but the specific encounter when it occurred. Materials and Methods We design and validate multi-modal algorithms to phenotype STEMI on a multicenter EHR containing 5.1 million patients and 115 million patient encounters by using discharge summaries, diagnosis codes, electrocardiography readings, and the presence of cardiac catheterizations on the encounter. Results We demonstrate that robustly phenotyping STEMIs by selecting discharge summaries containing “STEM” has the potential to capture the most number of STEMIs (positive predictive value [PPV] = 0.36, N = 2110), but that addition of a STEMI-related International Classification of Disease (ICD) code and cardiac catheterizations to these summaries yields the highest precision (PPV = 0.94, N = 952). Discussion and Conclusion In this study, we demonstrate that the incorporation of percutaneous coronary intervention increases the PPV for detecting STEMI-related patient encounters from the EHR.

Delays in Presentation by Patients with ST Elevation Myocardial Infarction

2021 ◽  
Author(s):  
Suhaib Almashari ◽  
Yasir Al-Malki ◽  
Adil Al-Riyami ◽  
Sunil K Nadar
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Public Education ◽  
Primary Angioplasty ◽  
St Elevation Myocardial Infarction ◽  
University Hospital ◽  
Sultan Qaboos University ◽  
Early Evaluation ◽  
St Elevation ◽  
Patient Factor

Objectives: To assess causes of delay for presentation with ST elevation myocardial infarction (STEMI) at our institution. Methods: We included patients with a STEMI that were taken up for primary angioplasty, who had presented from Jan 2017 to December 2019 to the emergency department at Sultan Qaboos university hospital, Muscat. Results: 101 patients (Mean age 54.8+10.8 years; 80 (79.2%) male) were included. The median (IQR) pain to door time was 60 (30-120) minutes.  66 (66%) patients arrived within 90 minutes. All except one arrived by privately arranged transport. Feeling that the pain was not important (60%) or not cardiac (22%) were the main reasons for delay. Being diabetic was the only patient factor that predicted delay. Conclusion: A high proportion of patients presenting to our institution with a STEMI arrived within recommended times. However more public education is required to improve awareness about the importance of early evaluation of chest pain. Keywords: Acute myocardial infarction; prehospital delay

Hospital delay in South Asian patients with acute ST-elevation myocardial infarction in the UK

2012 ◽  
Vol 20 (5) ◽  
pp. 737-742 ◽  
Author(s):  
Heather Kendall ◽  
Alexandra Marley ◽  
Jeetesh V Patel ◽  
Jawad M Khan ◽  
Andrew D Blann ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
South Asian ◽  
St Elevation Myocardial Infarction ◽  
Asian Patients ◽  
St Elevation ◽  
The Uk

Developing primary PCI as a national reperfusion strategy for patients with ST-elevation myocardial infarction: the UK experience

2012 ◽  
Vol 8 (P) ◽  
pp. P99-P107 ◽  
Author(s):  
James M. McLenachan ◽  
Huon H. Gray ◽  
Mark A. de Belder ◽  
Peter F. Ludman ◽  
David Cunningham ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Primary Pci ◽  
St Elevation ◽  
The Uk ◽  
Reperfusion Strategy

Impact of a Region-Wide Approach to Improving Systems for Heart Attack Care: The West Midlands Thrombolysis Project

2003 ◽  
Vol 2 (2) ◽  
pp. 131-139 ◽  
Author(s):  
Tom Quinn ◽  
Teresa F Allan ◽  
John Birkhead ◽  
Rod Griffiths ◽  
Sylvia Gyde ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Heart Attack ◽  
National Standard ◽  
Hospital Treatment ◽  
First Year ◽  
Discharge Diagnosis ◽  
The West ◽  
The Third ◽  
West Midlands

Objective: To describe changes in delay to administration of thrombolytic therapy associated with a region-wide audit. Design: Observational study of patients admitted with suspected myocardial infarction (MI) based on continuous audit. Subjects: 18877 patients admitted to 23 hospitals with suspected MI between April 1995 and March 1998. Results: Of 11232 patients with a discharge diagnosis of definite MI, 8802 (46.6%) received thrombolytic therapy during hospitalisation, with 5155 patients eligible for treatment on admission to hospital on the basis of established indications. Call-to-needle time for those eligible for treatment on admission fell from median 105 min in the first year of the project to 85 min in year 3 ( P<0.001), and door-to-needle time fell from 45 to 35 min ( P<0.001). Forty percent of eligible patients were treated within the then current national standard of 90 min from time of call for help, with nearly 49% in the final year and 20% being treated within the new national standard of 60 min, by the third year. Conclusion: The proportion of eligible patients receiving thrombolysis within 1 h of the call for help doubled during the 3-year project but the majority of patients still wait longer than 60-min ‘call-to-needle’. New systems to reduce delays to administration of thrombolysis to within 60 min of call for help are required, including consideration of pre-hospital treatment.

Time from ECG Diagnosis to sheath insertion is a strong predictor for mortality in patients with ST elevation myocardial infarction admitted for primary percutaneous coronary intervention

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.I Larsen ◽  
K Loland ◽  
S Hovland ◽  
O Bleie ◽  
T Trovik ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Strong Predictor ◽  
Public Institution ◽  
St Elevation Myocardial Infarction ◽  
University Hospital ◽  
P Value ◽  
Funding Source ◽  
Invasive Cardiology ◽  
St Elevation ◽  
Sheath Insertion

Abstract Introduction If reperfusion can be performed within 120 minutes, pPCI is the ESC guideline recommended treatment in patients with ST-elevation myocardial infarction (STEMI). Aims Historically, prognosis is dependent on time from diagnosis to reperfusion in patients with STEMI. We sought to investigate this in a contemporary patient population by assessing mortality as function of time from ECG diagnosis to sheath insertion in the Norwegian registry for invasive cardiology (NORIC). Methods NORIC, which is a part of the Norwegian Cardiovascular Disease Registry, is a national, mandatory and non-consensual person-identifiable health registry. Data from NORIC were linked with the National Population Register. Data were registered from 1st of January 2013 to 31st of June 2019. Results During this period complete data were available for n=5754 patients with 526 events. ECG diagnosis to sheath insertion was a predictor of mortality with the 4th (&gt;106 min) vs 1st quartile (&lt;54 min) with a HR of 1.74 (95% CI 1.36–2.22), p-value &lt;0.00001. The HR increased by 1.20 (95% CI 1.11–1.30) per quartile (p-value for trend &lt;0.00001). Nationally 62% percent of the patients received pPCI within the ESC recommended 90 minutes from ECG-diagnosis with large geographical variation (range 38–89%). Nationally 80% received pPCI within 115 minutes (range 75–202 minutes). Conclusion In a contemporary STEMI population, time from ECG diagnosis to sheath insertion is a strong predictor for mortality in patients admitted for pPCI for STEMI. However, the data also demonstrate large variations between different geographical health regions in Norway that should be addressed. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Haukeland University Hospital

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