European Journal of Biomedical and Pharmaceutical Sciences

DETERMINANTS OF OUTCOME AMONG PATIENTS ATTENDING CARDIAC EMERGENCY WITH ACUTE CHEST PAIN OF CARDIAC ORIGIN IN LUCKNOW DISTRICT, UTTAR PRADESH, INDIA

Prashantha B*, MZ Idris, N Ahmad, M Agarwal, SC Yadav, VK Singh

ABSTRACT

ABSTRACT Background: India, accounts for 5.24 million deaths annually due to NCD s and 20 DALY s lost per 1000 population per year due to cardiovascular diseases. They also contribute to 35.3% of total morbidity. Objectives: To study the distribution of outcome and the factors contributing to complications and non-survival in patients attending cardiac emergency with acute chest pain of cardiac origin in Lucknow district. Material and Methods: A Descriptive Longitudinal Study was conducted in the cardiac emergency of CSMMU, a tertiary care center, following systematic random sampling technique on a sample size of 220 during study period of one year August 2010 to August 2011. Data was collected through preformed and pretested schedule and analysed using SPSS 17.0 software. Results: The rate of complications during hospital stay was about 29.1%, out of which 29.7% were persistent and the commonest complication was arrhythmias (22.3%), followed by LVF (7.3%). The rate of complications after 3 months of follow up was about 21%, out of which 27.9% were persistent and the commonest complication was recurrence of chest pain (9.5%), followed by LVF (6.3%). Overall in-hospital mortality rate of patients with acute chest pain of cardiac origin was 5% and total mortality rate upto 3 months of follow up was 13.7%. The factors responsible for complications in patients with acute chest pain of cardiac origin were: uncontrolled DM,stage I and stage II hypertension, presence of dyslipidaemia, lack of regular exercise and lower socio-economic class. The factors leading to non-survival were: uncontrolled DM, stage I and stage II hypertension, presence of LVF at admission, having renal or electrolyte abnormalities, LVEF <40 % and having BPL card. Conclusions: IEC activities should be targeted to the high risk groups on short term approach to educate about the immediate action that can be taken after chest pain and about the appropriate health centers for treatment of chest pain so that some lives can be saved before reaching the hospital. As pain onset during night was associated with the delay and delay in arranging transport was significantly associated with the adverse cardiac outcomes, calling for help and ambulance services should be made available to the people with acute chest pain.

Keywords: Outcome, Acute Chest Pain, Cardiac Emergency, Seeking Health Care.