Time to treatment in patients of suspected acute coronary syndrome in Pakistan: a clinical audit

Abstract

Objective: Evaluate time to treatment (TT) in suspected acute coronary syndrome (ACS) patients in the Emergency Department (ED) in Pakistan.

Methods: In this clinical audit, medical records of adult patients with suspicion of ACS visiting the ED of a tertiary care facility in Karachi from January to March of 2012 were reviewed and evaluated according to benchmarks from American College of Cardiology/American Heart Association guidelines.

Results: Study included 230 patients, of which 62.6% were males (n = 144). Physicians saw most patients (74.1%) in ≤10 min (min) of ED triage. ECG was performed in ≤10 min in 93 (47.7%) patients. Of the 207 patients being prescribed Aspirin, 41.9% received it in ≤10 min. Of 155 patients who were prescribed anti-coagulants (e.g., heparin), 32.9% received them in 10 min. Half of the patients requiring primary coronary intervention underwent the procedure within 90 min.

Conclusion: Findings warrant exploring interventions to improve TT for ACS care in resource-limited settings.

Keywords: Acute coronary syndrome; Audit; Emergency department; Pakistan; Quality improvement.