Time to Seek Care and Hospital Length of Stay Among Older Adults With Acute Coronary Syndrome During the COVID-19 Pandemic

2021 ◽  
pp. 105477382110401
Author(s):  
Audai A. Hayajneh ◽  
Mohammad Rababa ◽  
Sami Al-Rawashedeh
Keyword(s):  
Older Adults ◽  
Acute Coronary Syndrome ◽  
Cross Sectional Study ◽  
Abrupt Onset ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Prehospital Delay ◽  
Coronary Syndrome

The prevalence of prehospital delay is high among older adults with acute coronary syndrome (ACS). The current study aimed to examine the associated factors of prehospital delay among patients with ACS during the COVID-19 pandemic. This cross-sectional study was conducted on a convenience sample of 300 older adults with ACS admitted to the emergency department in Jordan. Data were collected from June 1 to September 1, 2020. Bivariate and multivariate analyses were used to explore the predictors of prehospital delay. Being widowed, educational level, pain intensity, the gradual onset of ACS symptoms, symptoms lasting for more than 30 minutes, patients’ feeling anxious about their ACS symptoms, patients’ perceiving their symptoms to be particularly dangerous, history of myocardial infarction (MI), and mode of transportation were associated with the time taken before seeking emergency care. Significant predictors of time to seek help were chief complaint of chest pain or palpitations, abrupt onset of symptoms, the associated symptom of vertigo, and a higher number of chronic illnesses; they explained about 17.9% of the variance in the time to seek care. The average time to seek care among patients with ACS during the COVID-19 pandemic was found to be longer than the average time reported by studies conducted prior the pandemic. Improved understanding of the associations between prehospital delay is crucial for optimal ACS patient outcomes under the impacts of the COVID-19 pandemic.

scholarly journals The COVID-19 Pandemic Influencing Prehospital Delay Among Older Adult Patients with Acute Coronary Syndrome Seeking Emergency Care

2020 ◽  
Author(s):  
Audai Hayajneh ◽  
Mohammad Rababa ◽  
Sami Al-Rawashdeh
Keyword(s):  
Older Adults ◽  
Acute Coronary Syndrome ◽  
Emergency Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Prehospital Delay ◽  
Coronary Syndrome ◽  
Adverse Health Outcomes ◽  
Myocardial Infraction

Background: The prevalence of prehospital delay is high among older adults with acute coronary syndrome (ACS), resulting in adverse health outcomes. The current study aimed to examine the associated factors of prehospital delay among patients with ACS during the COVID-19 pandemic. Methods: This cross-sectional study was conducted on a convenience sample of 300 older adults with ACS admitted to the emergency department. Bivariate and multivariate analyses, including stepwise linear regression, were used to explore the predictors of prehospital delay and length of stay. Results: Being widowed, education, pain intensity, the gradual onset of ACS symptoms, symptoms lasting for more than 30 minutes, feeling anxious about their ACS symptoms due to the COVID-19 pandemic, perceiving their symptoms as dangerous due to the COVID-19 pandemic, history of myocardial infraction (MI), and mode of transportation were associated with the time taken before seeking emergency care among older adults with ACS during the COVID-19 pandemic. Conclusion: Length of prehospital delay among the participants varied according to certain sociodemographic and clinical characteristics and biomarkers. Improved understanding of the associations between prehospital delay and these characteristics is crucial for achieving optimal ACS patient outcomes under the impacts of the COVID-19 pandemic.

scholarly journals Willingness to Participate in Vaccine-Related Clinical Trials among Older Adults

2018 ◽  
Vol 15 (8) ◽  
pp. 1743 ◽  
Author(s):  
Divyanshu Raheja ◽  
Evelyn Davila ◽  
Eric Johnson ◽  
Rijalda Deović ◽  
Michele Paine ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Trials ◽  
Clinical Research ◽  
Elderly Person ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Willingness To Participate ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Research Findings

The purpose of this study is to understand among a convenience sample of 400 adults aged 60 years of age or older (1) reasons for being willing or unwilling to participate in a vaccine clinical research study and (2) overall perceptions about vaccine clinical research. A cross-sectional study using a sample of older adults residing in the metro-Atlanta area and surrounding neighborhoods was conducted. The study questionnaire contained 37 questions, including questions about socio-demographics and perceptions about clinical trial processes. Statistical analysis was conducted using logistic regression. The adjusted modeling results indicated that sex, distance to research clinic, and being informed about the research findings played a role in the likelihood of an elderly person participating in a vaccine study. Males were more likely to participate in clinical trials as compared to females (OR: 2.486; CI: 1.042–5.934). Most participants were willing to travel up to 25 miles from the research clinic. Of the respondents, 45% were unlikely to participate if the results of the current trial are not shared. Improving access to clinical trials in terms of distance traveled and ensuring streamlined processes to inform participants about the results of the trial in the future would increase willingness to participate in vaccine clinical trials. The survey could serve as a useful tool for conducting vaccine studies and other clinical trials by understanding the barriers specific to the elderly.

scholarly journals Prevalence of Cardiac Depression and its Related Factors among Patients with Acute Coronary Syndrome

2016 ◽  
Vol 8 (1) ◽  
pp. 30 ◽  
Author(s):  
Amir Hossein Goudarzian ◽  
Hamid Sharif Nia ◽  
Heydar Tavakoli ◽  
Mohammad Ali Soleimani ◽  
Ameneh Yaghoobzadeh ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Depression Score ◽  
Chi Square ◽  
Related Factors ◽  
Cross Sectional ◽  
Psychological Reactions ◽  
Coronary Syndrome ◽  
Cardiac Depression

Cardiac depression is one of the most common psychological reactions of patients with acute coronary syndrome (ACS). This study aimed to determine the prevalence of cardiac depression and its related factors among patients with ACS. This cross-sectional study was conducted during 2016 in patients with ACS who were admitted to hospitals affiliated to the Mazandaran University of Medical Sciences, Iran. In the present study, 407 patients completed the Cardiac Depression Scale (CDS) within two months (March - June). The data were analyzed by a chi-square test and a general linear model multivariate analysis. According to the results, the mean cardiac depression score in patients with ACS was 109.00 ± 16.49 (CI95: 107.39 to 110.60). Among the participants, 37 (9.1%), 72 (17.7%), and 298 (73.2%) patients had mild, moderate, and severe levels of depression, respectively. Although the two-way ANOVA was not significant, but there was a difference between cardiac depression score of a type of ACS. Given the high prevalence of cardiac depression among these patients, it is necessary to develop measures for routine screening in cardiac treatment units.

STUDY ON EVALUATION OF SERUM GAMMA-GLUTAMYL TRANSFERASE (GGT) LEVELS IN ACUTE CORONARY SYNDROME

2021 ◽  
pp. 39-40
Author(s):  
Avtar Singh Dhanju ◽  
Deepshikha Singla ◽  
Pashaura Singh ◽  
Ajay Chhabra ◽  
Sukhraj Kaur
Keyword(s):  
Acute Coronary Syndrome ◽  
Cross Sectional Study ◽  
Gamma Glutamyl Transferase ◽  
Cross Sectional ◽  
Gamma Glutamyl ◽  
Coronary Syndrome ◽  
Healthy Control ◽  
Group A ◽  
Group B ◽  
Glutamyl Transferase

Aim: The present study was undertaken with the aim to evaluate serum Gamma Glutamyl Transferase (GGT) levels in patients of acute coronary syndrome. Methodology: This cross-sectional study was conducted on 50 cases with acute coronary syndrome (Group A) and 50 healthy control subjects (Group B) meeting inclusion and exclusion criteria. Results: There is signicant rise in serum GGT levels in patients presenting with ACS in Group A as compared to Group B. Conclusion: Higher levels of GGT in ACS patients with risk factors such as hypertension, dyslipidemia and smoking may serve as biomarker to predict the occurrence of ACS.

Physical activity levels in hospitalised adults with burn injuries

2021 ◽  
Author(s):  
Anita Plaza ◽  
Julie Adsett ◽  
Angela Byrnes ◽  
Prue McRae
Keyword(s):  
Physical Activity ◽  
Total Body Surface Area ◽  
Physical Activity Behaviour ◽  
Cross Sectional Study ◽  
Hospital Length ◽  
Burn Injuries ◽  
Hospital Length Of Stay ◽  
Activity Levels ◽  
Cross Sectional ◽  
Activity Behaviour

Abstract Physical activity behaviour has not been previously described in hospitalised adults with burn injuries. This prospective, cross-sectional study used a standardised behavioural mapping protocol to observe patient behaviour related to physical activity over a 12-hour period on one weekday in a quaternary referral specialist burn centre. Structured observations were recorded for each of four domains: 1) patient location, 2) position, 3) activity performed and 4) the presence of others. Observations were summarised across all participants as median (IQR) proportion of time. Participants (n=17) were predominantly male (82%) with a mean age of 44.3 (SD 15.2) years, a mean burn size of 34.9% (SD 26.7) total body surface area and a median hospital length of stay of 18 (IQR 6-49) days at time of observation. Participants spent a median of 83% (IQR 73-93) of time in their bedroom, 92% (IQR 68-97) of time in or on their bed and a median of 5% (IQR 3-13) of time mobilising. Exercise accounted for 10% (IQR 8-17) of activity related observations. A median of 68% (IQR 39-83) of time was spent alone. Results suggest time spent engaging in physical activity is low. Further studies are required to investigate motivators and barriers to performing physical activity in this population. This will consequently inform the development and implementation of appropriate strategies to improve physical activity behaviour in this cohort.

scholarly journals Chest discomfort at night and risk of acute coronary syndrome: cross-sectional study of telephone conversations

2020 ◽  
Vol 37 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Loes T Wouters ◽  
Dorien L Zwart ◽  
Daphne C Erkelens ◽  
Noël S Cheung ◽  
Esther de Groot ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Risk Ratio ◽  
Patient Characteristics ◽  
Final Diagnosis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Chest Discomfort ◽  
Cross Sectional ◽  
Adjusted Risk ◽  
Coronary Syndrome

Abstract Background During telephone triage, it is difficult to assign adequate urgency to patients with chest discomfort. Considering the time of calling could be helpful. Objective To assess the risk of acute coronary syndrome (ACS) in certain time periods and whether sex influences this risk. Methods Cross-sectional study of 1655 recordings of telephone conversations of patients who called the out-of-hours services primary care (OHS-PC) for chest discomfort. Call time, patient characteristics, symptoms, medical history and urgency allocation of the triage conversations were collected. The final diagnosis of each call was retrieved at the patient’s general practice. Absolute numbers of patients with and without ACS were plotted and risks per hour were calculated. The risk ratio of ACS at night (0 to 9 am) was calculated by comparing to the risk at other hours and was adjusted for gender and age. Results The mean age of callers was 58.9 (standard deviation ±19.5) years, 55.5% were women and, in total, 199 (12.0%) had an ACS. The crude risk ratio for an ACS at night was 1.80 (confidence interval 1.39–2.34, P < 0.001): 2.33 (1.68–3.22, P < 0.001) for men and 1.29 (0.83–1.99, P = 0.256) for women. The adjusted risk ratio for ACS of all people at night was 1.82 (1.07–3.10, P = 0.039). Conclusions Patients calling the OHS-PC for chest discomfort between 0 and 9 am have almost twice a higher risk of ACS than those calling other hours, a phenomenon more evident in men than in women. At night, dispatching ambulances more ‘straightaway’ could be considered for these patients with chest discomfort. Trial number NTR7331.

The Association Between Serum Procalcitonin Levels and Severity of Coronary Artery Disease Assessed by SYNTAX Score in Patients With Acute Coronary Syndrome

Angiology ◽  
2016 ◽  
Vol 68 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Ahmet Göktuğ Ertem ◽  
Tolga Han Efe ◽  
Çağrı Yayla ◽  
Mehmet Kadri Akboğa ◽  
Burak Açar ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Inflammatory Marker ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Syntax Score ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Artery Disease

The SYNTAX score (SX score) is a useful score for assessing the severity of coronary artery disease (CAD). Previous studies have demonstrated a close relationship between SX score and inflammation. Procalcitonin (PCT) is an early inflammatory marker, especially during sepsis. Thus, in this study, we aimed to investigate the relationship between SX score and serum PCT levels. A total of 545 patients were enrolled in this prospective cross-sectional study and were divided into 2 subgroups, according to their SX score. Serum PCT and high-sensitivity C-reactive protein levels were measured. Serum PCT levels were higher in the high SX score group compared to the low–intermediate SX score group ( P < .001). Serum PCT levels were an independent predictor of a high SX score in patients with acute coronary syndrome ( P = .001). As patients with a higher SX score had increased serum PCT levels on admission, serum PCT may be useful for identifying patients with severe CAD.

scholarly journals Frequency of CYP2C19*2 Allele in Patients with Acute Coronary Syndrome: A Cross-sectional Study from Central Kerala, India

2021 ◽  
Author(s):  
Christina Ann George ◽  
Shibu Thadathil Sreedharan ◽  
Smitha Kalarikkal Satheesan ◽  
Sindhu Panakkaparambil Surendranath
Keyword(s):  
Acute Coronary Syndrome ◽  
Cross Sectional Study ◽  
Government Medical College ◽  
Sectional Study ◽  
Therapy Failure ◽  
Cross Sectional ◽  
Medical College ◽  
Coronary Syndrome ◽  
Variant Genotype ◽  
Study Population

Introduction: Ischaemic Heart Diseases (IHD) are increasing at an alarming rate globally. Pharmacotherapy, the mainstay of management of IHD, has Dual Antiplatelet Therapy (DAPT) at its crux. DAPT, comprising of clopidogrel and aspirin, is used often for 12 months in medically managed Acute Coronary Syndrome (ACS). Clopidogrel being a prodrug, needs to be activated after ingestion, mainly by Cytochrome family of enzymes, for the desired pharmacological effects. Abnormal enzymes that convert clopidogrel to its active form can reduce the effectiveness of the drug. Therefore, Single Nucleotide Polymorphisms (SNPs) of the enzymes involved, would predispose the patient to therapy failure and recurrence of the illness. This study aims at identifying the presence of a genetic variant associated with clopidogrel responsiveness in patients with ACS. Aim: To estimate the frequency of CYP2C19*2 allele in patients with ACS presenting to Government Medical College, Thrissur, Kerala, India. Materials and Methods: Present study was a cross-sectional study done among 60 patients who presented to Government Medical College, Thrissur with ACS, between June 2018 to June 2019. Having obtained informed consent from the participants blood samples were collected in Ethylene diamine tetra-acetic Acid (EDTA) tubes. Samples were used to look for presence of CYP2C19*2 allele by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). Results: Out of 60 patients 38 were males and 22 were females. Most common age group was 61-65 years. The frequency of CYP2C19*2 allele was 41% in the study population and the variant genotype (AA/AG) was present in 62%. Conclusion: The variant genotype was found to be present in a high frequency in the study population implying the high risk for therapy failure in the study population. This asserts the need to probe the matter further, as the gene is also implicated in the metabolism of several other drugs. The introduction of pharmacogenomic testing prior to initiation of therapy may be therefore recommended for better treatment outcome. However, to validate the same, further studies with larger sample size may be necessary.

scholarly journals Depression in Acute Coronary Syndrome Patients: A Cross-sectional Study in Malaysia

2020 ◽  
Author(s):  
Wan Nor Asyikeen Wan Adnan ◽  
Siti Azrin Ab Hamid ◽  
Zatul Rathiah Sulong ◽  
Mohd Hashairi Fauzi
Keyword(s):  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Ischemic Heart ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Coronary Syndrome

Background and purpose: Linked with high mortality rate, depression is common among acute coronary syndrome (ACS) patients. The current study sought to identify the factors associated with depression among ACS patients in Malaysia. Materials and Methods: A cross-sectional study was conducted on 400 ACS patients in two Malaysian hospitals: Hospital Universiti Sains Malaysia (USM), Kelantan and Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. ACS patients were included if they were above 18 years of age, able to read and/or write in Bahasa Melayu language and had informed consent. Patients were excluded if they were intubated, had an altered mental status, mental retardation and had psychological problems prior to ACS. Depression in this study was defined as having dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest or involvement, anhedonia, and inertia among ACS patients. A questionnaire was distributed to all 400 ACS patients. Simple and multiple logistic regressions were used for data analysis. Results: The mean (standard deviation) age of ACS patients was 60.4 (11.3) years at Hospital USM and 61.2 (10.4) years at HSNZ. Nearly all of the depressive-ACS patients were Malay (79.4%), 85.9% were male, and 79.7% were married. Approximately 87.7% of depressive-ACS patients had ischemic heart disease, 87.1% had stroke, 83.4% had hyperlipidaemia, 81.8% had diabetes mellitus, and 80.7% had hypertension. The factors associated with depression were female gender (adjusted odd ratio (OR): 2.48, 95% confidence interval (CI): 1.50, 4.10, p<0.001) and ischemic heart disease (adjusted OR: 2.44, 95% CI: 1.41, 4.25, p=0.002). Conclusion: The results showed that female gender and ischemic heart disease were the most significant associated factors of depression among ACS patients.

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