Key result
ESC quality audit reveals timely AMI thrombolysis in only ~16% of eligible patients.
Why the study?
The quality of care for patients admitted with AMI in a low/middle income scenario was assessed using the 2017 ESC Quality of Care guidelines to identify performance gaps.
Observational (n=660)
No
Implementation of ESC quality metrics in a low/middle-income setting identified gaps in AMI care, highlighting opportunities to improve timely thrombolysis and secondary prevention enrollment.
Aim: This study assesses the quality of care for patients admitted with diagnosis of acute myocardial infarction (AMI) in a secondary general hospital located in Sancti-Spiritus, Cuba, in a low/middle income scenario (LMIS), using the 2017 European Society of Cardiology (ESC) Quality of Care Working Group’s guideline.Methods: Observational retrospective of admitted AMI in Sancti-Spiritus Camilo Cienfuegos General Hospital. An implemented electronic registry was used for data collection. Each patient was considered for eligibility for each of the eight domains of quality. A set of quality measures was derived from ESC guidelines. Organizational information was assessed by administrative review and interview.Results: Between 2017 and 2019, 660 patients with AMI were admitted to Camilo Cienfuegos General Hospital, most of them (72%), presented with features of ST-elevation myocardial infarction (STEMI). Thrombolytic were administered to 268 (72.4%) patients, 43 (16%) of them in less than 30 minutes of diagnosis. Dual Antiplatelet Therapy was administered to 98.1% of patients on admission. However, only 163 (34.8%) were enrolled in secondary prevention programs. No information regarding Patient Experience, nor 30-day adjusted mortality, was collected. Secondary prevention was accomplished, around 90%.Conclusion: Determination of quality metrics brought certain improvement on perception of the quality of care in this setting. Despite absence of coronary intervention, there is a chance to modify some performance measures, which are not directly related with this doubtful situation.
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Rodríguez-Ramos et al. (2020) conducted an observational in Acute Myocardial Infarction (n=660). Quality of care evaluation (ESC 2017 guidelines) was evaluated on Compliance with ESC quality indicators for AMI care.
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