Code infarction initiative of Bajio region, during the pandemic by COVID-19 in a reconversion hospital
Villar-Valencia, Cristian Adrián; Hernández-González, Martha Alicia; Borrayo-Sánchez, Gabriela; Celis-Quintal, Juan German; Solorio-Meza, Sergio Eduardo; Medina-Torres, Oscar Samuel; Gutiérrez-Galván, Maraí Xochitl; Rodríguez-Martínez, Braulio; Prado-Rodríguez, Luis Humberto; Vázquez-Morones, Ana Laura; Alatoma-Medina, Juan Pablo; Hernández-Estala, Jorge; Patiño-Amaya, Aristóteles; Magdaleno-Serrano, Hugo Ivan; Rodríguez-Déniz, Carmen; Arellano-Sotelo, Hugo; Nava-Hernández, Guillermo; Ramírez-Vázquez, Ricardo; Chimal-Flores, Marco Antonio; Alegría-Peredia, Emiliano; Ramos-González, Gerardo Rubén; Pérez-Benítez, Rigoberto; Bermúdez-Acévez, Erik; Valencia-Martínez, Hypatia; Segovia-Solís, Hugo; López-Varela, Manuel; Monroy-Córdoba, Doryan; Marmolejo-López, Adriana; Báez-Montes, Alfredo; Hernández-Cerqueda, Fabián; Nolasco-Muñoz, Luis Ricardo; Vargas-Ramírez, Luis Manuel; Celis-Quintal, Juan German; Bernal-Ruíz, Enrique Alfredo; Delgado-Sánchez, Anabella; Sánchez-López, José Manuel; Bautista-López, Germán Ramón; Acevedo-Gómez, Pablo Francisco; Acuña-Valerio, Jorge Francisco; González-Ortíz, Oracio; Hernández-Padilla, Adolfo Asahel; Solórzano-Vázquez, Marco Alejandro; Herrera, Noel Franco; González, Luis Jonathan; Reyes-Álvarez, José Miguel; Salinas-Cavazos, Iván Rosendo; Tiscareño-Villanueva, Ashby Daniel; Vidrio-Villaseñor, Ramiro; Fernández-Yáñez, Gabriel; Meza, Guadalupe; Nucamendi-Solórzano, Freeman Issac; Sandoval-Uribe, José de Jesús; Sotelo-García, Luis David; Zamoaya-Paz, Luis Carlos; Espriu, Donovan Fernando; García-Rodríguez, Román; López-Ibarra, Daniel Eugenio; López-Valencia, Andrea Janeth; Villar-Valencia, Cristian Adrián; Navarro-Pérez-Macedo, Javier
ABSTRACT
Introduction: acute myocardial infarction has a high prevalence and possibility of death if timely care is not given. It is possible that treatment could be delayed during a health crisis such as the COVID-19 pandemic.
Objective: the objective of this study was to evaluate the impact of the COVID-19 pandemic on the function of the infarction code in the High Specialty Medical Unit of our institution. The medical indicators of acute coronary ischemic syndrome with ST-segment elevation were compared at two times: before the COVID-19 pandemic and during it.
Material and methods: an ambispective, analytical, comparative cohort study was conducted, comparing the periods of February-September 2019 and February-September 2020, in the High Specialty Medical Unit, Centro Médico del Bajío number 1, Instituto Mexicano del Seguro Social, Leon, Guanajuato, Mexico. All patients older than 18 years with clinical, electrocardiographic, and enzymatic data of acute coronary ischemic syndrome, accepted in the medical network as infarction code registered in the National Registry of Acute Coronary Ischemic Syndromes (RENASCA) electronic case report form were included in the study.
Results: the independent samples t-test was used to determine the impact of the infarction code initiative based on the reperfusion therapies performed, the door-to-needle, the door-to-balloon time, and the ischemia time. There was a significant difference in the reperfusion strategy, with greater thrombolysis during the COVID-19 pandemic (57.4% versus 72.6%, odds ratio [OR] 1.97, 95% confidence interval [CI] 0.49-0.82, p < 0.001), as well as reperfusion criteria (21.03% versus 35.37%, OR 2.05, 95% CI 0.53-0.80, p < 0.0001). Mortality was not different between the time periods.
Conclusions: the COVID-19 pandemic has not impacted operation of the infarction code in the High Specialty Medical Unit Centro Médico del Bajío number 1 because the medical indicators of acute coronary ischemic syndrome with ST-segment elevation did not change.
