Evaluating the performance of Tunisian regional hospitals. Study Protocol of management delays of ST elevation myocardial infarction

Abstract

Research problem : ST Elevation Myocardial Infarction (STEMI+) is an absolute emergency. The young age of patients and the difficulty of access to care
remain the main characteristics of STEMI+ management in Tunisia. In the governorate of Béja, located in the Northwestern region of Tunisia, given the lack of
a cardiology interventional room in the hospital and in the private establishments of the region and the distance from the specialized centers of at least 127 km,
the patient is beyond 90 min of the transfer. This delay in care generates a heavy burden of morbidity and mortality. The main objective of this study will be to
audit the delays of management of patients presenting STEMI+ at the regional hospital of Béja (Tunisia) in accordance with the recommendations of learned
societies. Secondarily, we will identify factors associated with delayed presentation after the onset of clinical symptoms.

Investigation process : it will be a descriptive, exhaustive and prospective study, including patients admitted to the emergency and/or the cardiology department
of the regional hospital of Béja for STEMI+ during the study period. For each patient admitted for STEMI, the following data will be collected : sociodemographic
characteristics; medical history; cardiovascular risk factors; diagnostic and therapeutic management modalities; intra-hospital evolution; survival at 01 months
in relation to the current coronary episode and the estimation of the different management delays.

Research plan : ethical considerations will be respected, as well as the confidentiality and anonymity of the data. The study will last one year from the 1st
september 2022 to 31 august 2023. The results will allow us to describe the delays of management of patients with STEMI+ in the region of Béja (Tunisia). At
least 2 publications in international scientific journals are planned.