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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Utilization of emergency medical services by patients with acute coronary syndromes in the Arab Gulf States
Journal of Emergency Medicine, Volume 41, No. 3, Year 2011
Notification
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Description
Background: Emergency Medical Services (EMS) play a central role in caring for patients with acute coronary syndromes (ACS). To date, no data exist on utilization of EMS systems in the Arab Gulf States. Objective: To examine EMS use by patients with ACS in the Gulf Registry of Acute Coronary Events (Gulf RACE). Methods: Gulf RACE was a prospective, multinational study conducted in 2007 of all patients hospitalized with ACS in 65 centers in six Arab countries. Data were analyzed based on mode of presentation (EMS vs. other). Results: Of 7859 patients hospitalized with ACS through the emergency department (ED), only 1336 (17%) used EMS, with wide variation among countries (2% in Yemen to 37% in Oman). Younger age (odds ratio [OR] 1.09; 95% confidence interval [CI] 1.031.15 per 10-year decrement), presence of chest pain (OR 1.73; 95% CI 1.482.03), prior myocardial infarction (OR 1.58; 95% CI 1.341.86), prior percutaneous coronary intervention (OR 1.27; 95% CI 1.021.59), family history of premature coronary disease (OR 1.25; 95% CI 1.091.51), and current smoking (OR 1.30; 95% CI 1.131.50) were independently associated with not utilizing EMS. Patients with ST-segment elevation myocardial infarction/left bundle branch block myocardial infarction who were transported by EMS were significantly less likely to exhibit major delay in presentation, and were significantly more likely to receive favorable processes of care, including shorter door-to-electrocardiogram time, more frequent coronary reperfusion therapy, and thrombolytic therapy within 30 min of arrival at the ED. Conclusion: Despite current recommendations, fewer than 1 in 5 patients with ACS use EMS in the Arab Gulf States, highlighting a significant opportunity for improvement. Factors causing this underutilization deserve further investigation. Copyright © 2011 Elsevier Inc.
Authors & Co-Authors
Fares, Saleh
United States, Boston
Beth Israel Deaconess Medical Center
United States, Boston
Harvard Medical School
Zubaid, Mohammad
Kuwait, Kuwait City
Kuwait University
Al-Mahmeed, Wael Abdulrahman R.
United Arab Emirates, Abu Dhabi
Sheikh Khalifa Medical City
Ciottone, Gregory R.
United States, Boston
Beth Israel Deaconess Medical Center
United States, Boston
Harvard Medical School
Sayah, Assaad J.
United States, Boston
Harvard Medical School
United States, Cambridge
Emergency Department
Al Suwaidi, Jassim Mohd
Qatar, Doha
Hamad Medical Corporation
Amin, Haitham
Bahrain
Mohammad Bin Khalifa Cardiac Center
Al-Atawna, Farid
Kuwait, Safat
Al-amiri Hospital
Ridha, Mustafa
Kuwait, Hadiya
Adan Hospital
Sulaiman, Kadhim J.
Oman, Muscat
Royal Hospital
Alsheikh-Ali, Alawi A.
United Arab Emirates, Abu Dhabi
Sheikh Khalifa Medical City
United States, Medford
Tufts University
Statistics
Citations: 34
Authors: 11
Affiliations: 11
Identifiers
Doi:
10.1016/j.jemermed.2010.05.002
ISSN:
07364679
Research Areas
Maternal And Child Health
Study Design
Randomised Control Trial
Cohort Study
Case-Control Study