Browsing by Author "Poudel, Chandra Mani"
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Publication Emergency Heart Failure Mortality Risk Grade-7 Score Performance in Patients with Acute Heart Failure admitted at a Tertiary Care Center(Institute of Medicine, Tribhuvan University, 2024) Shrestha, Bikesh; Poudel, Chandra Mani; Gajurel,Ratna ManiAbstract: Introduction Heart failure is a major cause of morbidity and mortality worldwide with annual mortality of 8-9%. Acute heart failure patients require frequent Emergency Department visits and hospitalization.Emergency Heart Failure Mortality Risk Grade (EHMRG) score helps to risk stratify such patients. We aimed to study its performance at a tertiary care centre in Nepal. Methods This is an analytical, study involving 175 acute heart failure patients admitted at Emergency department over 1 year. The score was calculated for each patient and they were followed up for 30 days post discharge for readmission. The primary outcome studied was 7 day mortality. Results The median age was 66 years with 94 (53.7%) of the patients being male. Ischemic (38.3%) and dilated (25.1%) cardiomyopathies were the most common etiologies. Twenty seven (15.3%) of the patients required re-hospitalization within 1 month.There was statistically significant association (p<0.001) between 7-day mortality and high EHMRG scores (Class 5 and 4). No 7-day mortality was observed in the very low, low, and intermediate-risk groups. In the high-risk group (Class 4), 1 patient died while 15 survived. In the very high-risk group (Class 5), 29 patients died compared to 45 who survived. Conclusion Mortality within 7 days and readmission rates were higher in patients with high EHMRG scores. No mortalitites were encountered in patients with low scores. EHMRG can be a valuable tool to stratify acute heart failure patients as it can identify patients with high risk of 7 day mortality. It can help physician in deciding whether to discharge or admit the patients from Emergency rooms.Publication Occluded Coronary Artery among Non-ST Elevation Myocardial Infarction Patients in Department of Cardiology of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Sharma, Manju; Khanal, Raja Ram; Shah, Sangam; Gajurel, Ratna Mani; Poudel, Chandra Mani; Adhikari, Suman; Yadav, Vijay; Devkota, Surya; Thapa, ShovitAbstract Introduction: Non-ST elevation myocardial infarction is frequently thought to be caused by incomplete blockage of the culprit artery, whereas ST elevation myocardial infarction is frequently thought to be caused by total occlusion of the culprit artery. The objective of the study was to find out the prevalence of occluded coronary arteries among non-ST elevation myocardial infarction patients department of cardiology of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among non-ST elevation myocardial infarction patients in a tertiary care centre from 22 June 2020 to 21 June 2021 after taking ethical approval from the Institutional Review Committee [Reference number: 4271 (6-11) E2 076/077]. A total of 196 patients were included in the study by simple randomized sampling. Data on the patient’s clinical profile, angiographic findings, and in-hospital complications were recorded. Point estimate and 95% Confidence Interval were calculated. Results: Among 126 non-ST elevation myocardial infarction patients included in the study, the prevalence of occluded coronary artery was 41 (32.54%) (24.36-40.72, 95% Confidence Interval). Conclusions: The prevalence of occluded coronary arteries was similar to the studies done in similar settings.