Hassan Mohamed Omar, Ahmed Said Abdirahman, Hassan Mohamed Sheikh, Köprülü Diyar
Department of Cardiology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia.
Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia.
Int J Gen Med. 2024 Jan 22;17:237-244. doi: 10.2147/IJGM.S448750. eCollection 2024.
The door-to-balloon time, the time between a patient's arrival at the hospital and percutaneous coronary intervention, is crucial for managing myocardial infarction. Aiming for less than 90 minutes is recommended, as shortened times are associated with improved outcomes. However, limited healthcare resources, infrastructure, transportation and poverty impact management, leading to poorer outcomes and delayed door to balloon time. Addressing these challenges and their causes is essential for optimal care.
A retrospective analysis of 103 patients' medical history records from May 2022 to June 2023 at the Mogadishu Somali Turkish Training and Research Hospital in Somalia was conducted. The data was mainly collected from the hospital's electronic medical records system, analyzing patient demographics, clinical characteristics, and angiographical records. The study analyzed variables responsible for door-to-balloon (D2B) time delay, patient angiography results, cause of delay, procedure length, etc.
A study of 103 patients who had angiography performed between May 2022 and July 2023 was done. The predominant gender in the study was 73% male, with a mean age of 58 years. The most common risk factors were hypertension (33%), smoking (38%), and diabetes (39%). Of all the vessels, the Left Anterior Descending (LAD) was the most commonly obstructed (63%). Time delays from door-to-balloon were frequent, median door-to-balloon time was 169 minutes, frequently brought on by social problems and financial limitations. The majority (77.4%) of the patients had only percutaneous angiography (PCI), while 22.6% were recommended for bypass following PCI of the infarct-related artery (IRA). Complications in the delayed treatment group were the main cause of the death rate of 24.2%.
Door-to-balloon time is crucial for acute myocardial infarction treatment which is challenging in impoverished countries like Somalia. Investments in healthcare infrastructure, public health education, and emergency services can improve patient outcomes.
门球时间，即患者抵达医院至经皮冠状动脉介入治疗之间的时间，对于管理心肌梗死至关重要。建议目标时间少于90分钟，因为时间缩短与改善预后相关。然而，有限的医疗资源、基础设施、交通和贫困影响治疗，导致预后较差且门球时间延迟。应对这些挑战及其成因对于优化治疗至关重要。
对索马里摩加迪沙索马里土耳其培训和研究医院2022年5月至2023年6月期间103例患者的病史记录进行回顾性分析。数据主要从医院的电子病历系统收集，分析患者人口统计学、临床特征和血管造影记录。该研究分析了导致门球（D2B）时间延迟的变量、患者血管造影结果、延迟原因、手术时长等。
对2022年5月至2023年7月期间进行血管造影的103例患者进行了研究。研究中男性占主导，占73%，平均年龄为58岁。最常见的危险因素是高血压（33%）、吸烟（38%）和糖尿病（39%）。在所有血管中，左前降支（LAD）是最常阻塞的血管（63%）。门球时间延迟很常见，门球时间中位数为169分钟，这通常是由社会问题和经济限制导致的。大多数患者（77.4%）仅接受经皮血管造影（PCI），而22.6%的患者在梗死相关动脉（IRA）进行PCI后被建议进行搭桥手术。延迟治疗组的并发症是死亡率达24.2%的主要原因。
门球时间对于急性心肌梗死治疗至关重要，而在索马里等贫困国家，这一治疗颇具挑战性。对医疗基础设施、公共健康教育和急诊服务的投资可改善患者预后。
