Management quality indicators and in-hospital mortality among acute coronary syndrome patients admitted to tertiary hospitals in Ethiopia: prospective observational study

• Published in: BMC emergency medicine 2021-03, Vol.21 (1), p.41-41, Article 41
• Main Authors: Fanta, Korinan, Daba, Fekede Bekele, Tegene, Elsah, Melaku, Tsegaye, Fekadu, Ginenus, Chelkeba, Legese
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Acute coronary syndromes; Analysis; Aspirin; Beta blockers; Biomarkers; Cardiac catheterization; Cardiac patients; Cardiology; Cardiovascular agents; Cardiovascular disease; Cardiovascular diseases; Clinical outcomes; Consent; Coronary heart disease; Data collection; Developed countries; Disease prevention; Electrocardiography; Emergency medical care; Ethiopia; Evidence-based medicine; Globalization; Heart attacks; Hospitalization; Hospitals; Indicators; Intubation; Laboratories; Management quality indicators; Medical care; Medical imaging; Morbidity; Mortality; Myocardial infarction; Observational studies; Patient outcomes; Patients; Quality control; Quality management; Reperfusion; Risk factors; Sociodemographics; Statins; Statistical analysis; Sub-Saharan Africa; Transluminal angioplasty
• ISSN: 1471-227X; 1471-227X
• DOI: 10.1186/s12873-021-00433-3

Acute coronary syndrome (ACS) remains the leading cause of cardiovascular disease mortality and morbidity worldwide. While the management quality measures and clinical outcomes of patients with ACS have been evaluated widely in developed countries, inadequate data are available from sub-Saharan Africa countries. So, this study aimed to assess the clinical profiles, management quality indicators, and in-hospital outcomes of patients with ACS in Ethiopia. A Prospective observational study was conducted at two tertiary hospitals in Ethiopia from March 2018 to November 2018. The primary outcome of the study was in-hospital mortality. Data were analyzed using SPSS version 23.0. Multivariable cox-regression was conducted to identify predictors of time to in-hospital mortality. Variable with p -value  90%) while other medications were sub-optimal ( 12 h (AHR: 4.23, 95% CI: 1.28-13.81), and Cardiogenic shock (AHR: 7.20, 95% CI: 3.55-14.55) were independent predictors of time to in-hospital death among ACS patients. In the present study, the use of guideline-directed in-hospital medications was sub-optimal. The overall in-hospital mortality rate was unacceptably high and highlights the urgent need for national quality-improvement focusing on timely initiation of evidence-based medications, reperfusion therapy, and strategies to reduce pre-hospital delay.