Recovery Rate and Predictors Among Patients with Acute Coronary Syndrome in Addis Ababa, Ethiopia: A Retrospective Cohort Study

Abstract

Background: Coronary artery disease (CAD) is the leading cause of mortality and morbidity in the world, including Ethiopia. Over seven million people die annually due to acute coronary syndrome (ACS) secondary to CAD. Despite this fact, studies are scant in Ethiopia. Objective: To determine recovery rate and predictors of time to recovery among ACS patients in St. Peter’s Specialized Hospital, Addis Ababa, Ethiopia from October 2017 to October 2019. Methodology: A retrospective cohort study was conducted among ACS patients. Patient charts were reviewed using a structured checklist. The Kaplan–Meier survival curve was used to estimate the survival time. Log–log plots were used to check proportional hazard assumption among categorical predictors. Bivariable and multivariable Cox regression ana-lyses were performed to identify predictors of time to recovery. In bivariable analysis, variables with P ≤0.25 were fitted for multivariable Cox regression. Factors with P <0.05 in the multivariable Cox regression were independent predictors of time to recovery. Results: A total of 471 patient charts with a diagnosis of ACS were reviewed. The mean length of hospital stay was 2.98 ±1.30 days with a total follow-up time of 1397 person-days. The recovery rate was 61.8%. The incidence density rate of recovery was found to be 20.5 per 100 person-days. Percutaneous coronary intervention (PCI) (AHR = 2.08, 95% CI: 1.57, 2.74) and absence of major bleeding (AHR = 1.44, 95% CI: 1.11, 1.87) were predictors of time to recovery. Conclusion: In the current study, a considerable number of patients recovered within the first few days of admission. Absence of major bleeding and PCI were found to enhance early recovery of patients. Hence, early implementation of PCI and treatment of major bleeding may be vital to augment early recovery of patients with ACS. This can be achieved through involving case managers who can enhance the quality of treatment.