Key result
Among 300 acute coronary syndrome patients with 35.3% in-hospital mortality, Killip class III/IV strongly predicted death compared to class I/II (AOR 10.13, 95% CI 4.36-23.55, P<0.001).
Why the study?
In-hospital mortality from ACS remains high in sub-Saharan countries despite the introduction of thrombolytic treatments and limited percutaneous coronary intervention, prompting this evaluation of treatment outcomes and associated factors at a tertiary medical center in Ethiopia.
What are the in-hospital treatment outcomes and associated prognostic factors among adults admitted with acute coronary syndrome in a tertiary teaching hospital in Ethiopia?
Cross-Sectional (n=300)
No
What are the in-hospital treatment outcomes and associated prognostic factors among adults admitted with acute coronary syndrome in a tertiary teaching hospital in Ethiopia?
Answers are grounded in this paper and cite their sources.
This study highlights an exceptionally high in-hospital mortality rate (35.3%) among ACS patients in a tertiary Ethiopian hospital, driven by severe pre-hospital presentation delays (mean 79.6 hours), lack of PCI, minimal thrombolysis use (2.5% in STEMI), and high-risk clinical features including older age, diabetes, STEMI, advanced Killip class, and LVEF <=30%.
In developing countries, acute coronary syndrome (ACS) is becoming a more common cause of cardiovascular death. Although thrombolytic treatments and limited percutaneous coronary intervention have been introduced, in-hospital mortality from ACS is still high in sub-Saharan countries. This study aimed to evaluate the treatment outcome of ACS and its associated factors among patients attending Jimma University Medical Center, Jimma, Ethiopia. A retrospective hospital-based cross-sectional study was conducted among 300 ACS patients. Patient records from admissions between November 1st, 2017, and October 31st, 2022 were reviewed, with data collected between December 1(st) and 31(st), 2022. Data were collected using a structured checklist, entered, and analyzed using Statistical Package for Social science version 26. Descriptive analysis was used to summarize baseline characteristics and determine treatment outcomes. Bivariable and multivariable regression analyses were employed to determine factors affecting poor treatment outcomes. The odds ratio with a 95% confidence interval was computed, and a P value < .05 was considered significant. Among the 300 ACS patients included in our study, 35.3% died during hospitalization. Hypertension was the most common risk factor, present in 88.3% of the patients. In addition, 20.3% were classified as Killip class III or IV. 20.7% had a left ventricular ejection fraction (LVEF) of less than or equal to 30%, and 79.3% had an LVEF > 30%. Regarding treatment, an aspirin loading dose, clopidogrel loading dose, beta-blockers, statins, morphine, and nitrates were given to 284 (94.7%), 286 (95.3%), 227 (75.7%), 283 (94.3%), 109 (36.3%), and 80 (26.7%) patients, respectively. Factors significantly associated with in-hospital mortality were older age (P ≤ .001), history of diabetes (P = .004), ST-segment elevation myocardial infarction diagnosis (P = .003), and Killip class III and IV (P ≤ .001), whereas LVEF > 30% was associated with significantly lower odds of in-hospital death (P < .001). The proportion of in-hospital mortality attributable to ACS was found to be high. As a result, timely evidence-based therapy should be included in the setup.
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Tegene et al. (2026) conducted a cross-sectional in Acute coronary syndrome (n=300). Killip class III and IV vs. Killip class I and II was evaluated on In-hospital mortality (OR 10.132, 95% CI 4.36-23.55, p=<0.001). Among 300 acute coronary syndrome patients with 35.3% in-hospital mortality, Killip class III/IV strongly predicted death compared to class I/II (AOR 10.13, 95% CI 4.36-23.55, P<0.001).
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