PATTERN OF ADMISSION, TREATMENT OUTCOME AND ASSOCIATED FACTORS OF ACUTE CORONARY SYNDROME IN PATIENTS ADMITTED TO HIWOT FANA COMPREHENSIVE SPECIALISED HOSPITAL, HARAR, EASTERN ETHIOPIA

Abstract

Background: Acute coronary syndrome is the leading cause of death and disability-adjusted life years globally, with low- and middle-income countries bearing a high proportion of the burden. Despite increasing burden of ischemic heart disease in Ethiopia, acute coronary syndrome is a forgotten domain and a few data are available. Objectives: To assess the pattern of admission, treatment outcome and associated factors of acute coronary syndrome in Hiwot Fana Comprehensive Specialized hospital, in time period of August 1 2020 to July 2023 Harar, Ethiopia, 2023. Method: Institutional based cross-sectional study was employed on 216 randomly selected acute coronary syndrome patients admitted to at Hiwot Fana comprehensive specialized hospital in time period of August 1 2020 to July 2023. Data was collected from medical records by using checklist adapted from literatures. The data was cleaned and entered in to Epi data version 4.2 and exported to Statistical Package for Social Science version 20.0 for analysis. Bivariable and Multivariable logistic regression analysis was done to identify factors associated with outcome of patients with acute coronary syndrome. All variables with a p-value of < 0.25 in the bivariable logistic regression analysis was entered into the multivariable analysis. Finally, significance was declared at a p-value < 0.05. Result: A total of 216 patients were analyzed in this study. The most common pattern of acute coronary syndrome was ST elevation myocardial infarction (110, 50.9%). The poor treatment outcome of acute coronary syndrome was 50 (23.2%).Patients who arrived at emergency department after 48 hours of onset of symptoms (Adjusted odd ratio: 4.74; 95% CI: 1.29-17.40) and diagnosis of Killip 3 and 4 (Adjusted odd ratio: 16.29; 95% CI: 5.70-46.56) were significantly associated with poor treatment of patients with acute coronary syndrome. Conclusion and recommendations: In this study, the poor treatment outcome of acute coronary syndrome was high. Patients who arrived at emergency department after 48 hours of onset of symptoms, patients with a diagnosis of killip 3 and 4 and age greater than 65 were associated with poor treatment outcome. So, focusing on this factor reduction as well as improving our management by targeting this factor is very important to reduce the associated mortality.