Abstract 9442: Acute Coronary Syndrome Treatment Delay in Low to Middle-Income Countries: A Systematic Review
Notice bibliographique
Résumé
Introduction: Although morbidity and mortality rates are declining for acute coronary syndrome (ACS) in most high-income countries, it is rising at an alarming pace for low to middle-income countries (LMICs), largely due to pre-hospital treatment delays. Purpose: This systematic review was conducted to determine the mean length of time from symptom onset to treatment in LMICs and the sociodemographic, clinical, and health system characteristics that contribute to treatment delays. Methods: A comprehensive review of the English literature was conducted between January 1990 through May 2020 using predefined criteria. Time to treatment was defined from ACS symptom onset to first medical contact and then further dichotomized as less than (early) or greater than 12-hours (late) treatment. Twenty-nine peer-reviewed studies, which comprised 29,731 subjects with ACS symptoms residing in 14 LMICs. Sample sizes in the studies ranged from 50 to 20,937. Age ranged from 28-72 years and the majority were males. The Newcastle-Ottawa Assessment Scale was utilized to measure study quality. Results: The mean time from symptom onset to first medical contact was 12.7 hours, ranging from10-minutes to 96 hours. Being older age, female gender, illiterate, rural residence, having atypical chest pain and lack of ACS symptom knowledge were associated with longer delays. Those directly admitted to an emergency department with the capacity to provide coronary interventions received earlier treatment. Community facilities where ECG machines were available had lower prehospital delay time for referral to reperfusion therapy facilities. Lack of emergency medical systems, poor communication between the community and interventional facilities were also major contributors to ACS treatment delays. Conclusions: Pre-hospital delay time remains an important contributor to poorer clinical outcomes and higher mortality in LMICs. Country-wide referral plans are urgently needed to ensure timely transfer of patients from non-cardiac centers to interventional facilities. Health education through the different media outlets will raise awareness of ACS risk factors, accompanying signs and symptoms as well as the need to seek early treatment to improve clinical outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,006 | 0,002 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».