Impact of AMI Standard Clinical Pathway on Clinical Outcomes in the Management of Acute Myocardial Infarction Patient in a Public Tertiary Care Hospital, Karachi-Pakistan

Author(s):

Tarique Ahmed*,Paracha MY, Bella Khan, Suresh K, Tahir Hussain, Abdul mueed, Sahito S, Ayesha Basir

Introduction: AMI (Acute Myocardial infraction) is now a days being viral in world and most of the patients are being died by this. This disease affects the heart tissue or muscles indirectly due to shortage of oxygen supply in the heart. This can lead to the abnormality in the heart functioning which can affect the systolic and diastolic levels of a patient, and due to which the blood pressure may decrease or increase suddenly on the basis of heart pumping rate slow or high. Acute myocardial infractions are observed from the clinical perspectives like by testing the change in ECG. It can also be intercept by the pain in chest. Objective: To determine the impact of Acute Myocardial Infarction Standard Clinical Pathway on clinical outcomes in the management of Acute Myocardial Infarction patient in a public tertiary care hospital, KarachiNational Institute of Cardiovascular diseases Pakistan. Materials & Methods: Quasiexperimental non-randomized study design was conducted in the National Institute of Cardiovascular disease Karachi from September-December, 2018, comprised on Acute Myocardial Infarction (AMI) admitted patients on N=110 (55 control group and 55 intervention/post implementation groups) through health care professionals (HCPs). Patients were recruited through consecutive sampling; whereas, Health Care Professionals (HCPs) were recruited through purposive sampling. Results: It is observed that there were about 33 males and 22 females in pre implementation while there were 19 males and 36 females in the post implantation phase. From the results of demographic variables, there were 33 patients of DM and HTN in pre implementation of AMI clinical Pathway while they were 37 patients post implementation. There were 5 patients of TB for both pre and post implementation. There were 11 patients of IHD in pre implementation while 9 patients in post implementation. On the other hand, 6 patients of Asthma in pre implementation while they were 4 in post implementation. Conclusion: Implementation of AMI standard CP improves the clinical parameters of AMI admitted patients. Also reduce the Length of hospital Stay (LOS) of AMI admitted patients and improve quality of life. Reduce in LOS spectacularly seen in interventional group as compared to control group