Cardiac Center-King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
Cardiac Center-King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
Cardiovasc Revasc Med. 2021 Mar;24:20-23. doi: 10.1016/j.carrev.2020.09.012. Epub 2020 Sep 10.
During the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak of 2014, tertiary care cardiac centers shouldered the responsibility of caring for patients presenting with Acute Coronary Syndromes (ACS). This entailed designing algorithms that ensured timely management of patients with ACS in the setting of an emerging novel viral infection that was rapidly spreading within the community with a high infectivity and case fatality rate. The objective of this study is to describe a single center experience and the adopted pathway for the management of ACS.
This is a single center retrospective observational study of all patients who were admitted between March 1, 2014 and May 31, 2014 with an ACS. Total ACS admissions, bed turnover, procedures and healthcare personnels' infection rates were obtained from the annual statistics database and employee health records. All baseline characteristics, therapy received, outcomes and MERS-CoV status were obtained from the chart review.
A total of 148 patients with a diagnosis of ACS were admitted during that period of time. Of those, 59 had STEMI, 42 had NSTEMI and 47 had unstable angina. PCI was performed in 74, coronary artery bypass grafting (CABG) in 28 and conservative therapy was prescribed for 46 patients. The bed turnover was no higher than the previous or subsequent two months suggesting no change in practice. The infection rate of MERS-CoV was zero for healthcare workers.
In times of a national health crisis it is imperative that best practices are upheld to sustain existing resources, reduce bed occupancy and preserve medical personnel. A key component of such a strategy depends on assigning centers dedicated to isolating and treating the highly infectious disease outbreak while allowing other centers to provide expeditious cardiac care.
在 2014 年中东呼吸综合征冠状病毒（MERS-CoV）爆发期间，三级保健心脏中心承担了照顾出现急性冠状动脉综合征（ACS）的患者的责任。这需要设计算法，以确保在新兴的新型病毒感染迅速在社区内传播且具有高传染性和病死率的情况下，及时管理 ACS 患者。本研究的目的是描述一个中心的经验和采用的 ACS 管理途径。
这是一项对 2014 年 3 月 1 日至 5 月 31 日期间因 ACS 入院的所有患者进行的单中心回顾性观察性研究。从年度统计数据库和员工健康记录中获得 ACS 的总入院人数、病床周转率、手术和医护人员感染率。从图表审查中获得所有基线特征、接受的治疗、结果和 MERS-CoV 状态。
在此期间共收治 148 例 ACS 患者。其中，59 例为 ST 段抬高型心肌梗死，42 例为非 ST 段抬高型心肌梗死，47 例为不稳定型心绞痛。74 例行 PCI，28 例行冠状动脉旁路移植术（CABG），46 例给予保守治疗。病床周转率与前两个月或后两个月相同，表明实践没有变化。医护人员的 MERS-CoV 感染率为零。
在国家卫生危机时期，必须坚持最佳实践，以维持现有资源、降低病床占用率并保护医务人员。这种策略的一个关键组成部分取决于分配专门用于隔离和治疗高度传染性疾病爆发的中心，同时允许其他中心提供迅速的心脏护理。
