The impact of war on ACS admissions and triage – a single center experience

Introduction: Contemporary data regarding the impact of war on cardiovascular disease is scarce. The Israel-Gaza war that erupted on October 7th, 2023, provided a tragic opportunity to explore the effect of war on the epidemiology, characteristics, and management of patients with acute coronary synd...

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Main Authors: Sharon Bruoha, Tatiana Stolichny, Vladimir Chitoroga, Michael Shilo, Michael Friger, Jamal Jafari, Evgeny Chernogoz, Maggie Cohen Grisaru, Amos Katz, Chaim Yosefy, Gili Givaty
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Heliyon
Online Access:http://www.sciencedirect.com/science/article/pii/S2405844024172039
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author Sharon Bruoha
Tatiana Stolichny
Vladimir Chitoroga
Michael Shilo
Michael Friger
Jamal Jafari
Evgeny Chernogoz
Maggie Cohen Grisaru
Amos Katz
Chaim Yosefy
Gili Givaty
author_facet Sharon Bruoha
Tatiana Stolichny
Vladimir Chitoroga
Michael Shilo
Michael Friger
Jamal Jafari
Evgeny Chernogoz
Maggie Cohen Grisaru
Amos Katz
Chaim Yosefy
Gili Givaty
author_sort Sharon Bruoha
collection DOAJ
description Introduction: Contemporary data regarding the impact of war on cardiovascular disease is scarce. The Israel-Gaza war that erupted on October 7th, 2023, provided a tragic opportunity to explore the effect of war on the epidemiology, characteristics, and management of patients with acute coronary syndrome (ACS) living in areas of active armed conflict. Methods: All patients admitted with ACS to our medical center, between October 7th, 2023, and January 6th, 2024, were retrospectively included. Crucial time intervals in the management of individuals with ACS were collected in a predetermined spreadsheet. In-hospital and 30-day outcomes were obtained from the medical records and contrasted with ACS cases admitted in the period preceding the war. Results: A total of 449 individuals (102 females [22.7 %]) with a diagnosis of ACS were recruited, 358 patients (144 STEMI and 214 NSTEMI) were admitted during the 9 months before October 7th and 91 patients (42 STEMI and 49 NSTEMI) in the 3 months after October 7th. Compared to the control period, a significant reduction in ACS admissions per month was noted (38.91 vs. 28.79, p < 0.001) driven by fewer cases of both STEMI and NSTEMI (15.65 vs. 13.29, p = 0.011 and 23.26 vs. 15.5, p < 0.001, respectively). In patients with STEMI, the total ischemic time was similar before and after the war (179 min vs. 187 min, p = 0.849). Conclusions: War has a dramatic impact on cardiovascular incidence and outcomes which, however, are not necessarily linked to higher admission rates. Nevertheless, with the adoption of systematic approach and increased awareness, patients with ACS can be managed effectively even at times of extremely limited resources such as war.
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spelling doaj-art-934bdc5f5ba34c2b88386e3a14ad9fc52025-01-17T04:50:24ZengElsevierHeliyon2405-84402025-01-01111e41172The impact of war on ACS admissions and triage – a single center experienceSharon Bruoha0Tatiana Stolichny1Vladimir Chitoroga2Michael Shilo3Michael Friger4Jamal Jafari5Evgeny Chernogoz6Maggie Cohen Grisaru7Amos Katz8Chaim Yosefy9Gili Givaty10Department of Cardiology, Barzilai University Medical Center, Ashkelon and Faculty of Health Science, Ben-Gurion University of the Negev, Israel; Corresponding author. Barzilai medical center, Hahistadrout 2, Ashkelon, 7830604, Israel.Department of Cardiology, Barzilai University Medical Center, Ashkelon and Faculty of Health Science, Ben-Gurion University of the Negev, IsraelDepartment of Cardiology, Barzilai University Medical Center, Ashkelon and Faculty of Health Science, Ben-Gurion University of the Negev, IsraelDepartment of Epidemiology, Biostatistics and Community Health, Faculty of Health Science, Ben-Gurion University of the Negev, IsraelDepartment of Epidemiology, Biostatistics and Community Health, Faculty of Health Science, Ben-Gurion University of the Negev, IsraelDepartment of Cardiology, Barzilai University Medical Center, Ashkelon and Faculty of Health Science, Ben-Gurion University of the Negev, IsraelQuality Unit, Barzilai Medical Center, The Ben-Gurion University of the Negev, IsraelQuality Unit, Barzilai Medical Center, The Ben-Gurion University of the Negev, IsraelDepartment of Cardiology, Barzilai University Medical Center, Ashkelon and Faculty of Health Science, Ben-Gurion University of the Negev, IsraelDepartment of Cardiology, Barzilai University Medical Center, Ashkelon and Faculty of Health Science, Ben-Gurion University of the Negev, IsraelDepartment of Management, Barzilai Medical Center, The Ben-Gurion University of the Negev, IsraelIntroduction: Contemporary data regarding the impact of war on cardiovascular disease is scarce. The Israel-Gaza war that erupted on October 7th, 2023, provided a tragic opportunity to explore the effect of war on the epidemiology, characteristics, and management of patients with acute coronary syndrome (ACS) living in areas of active armed conflict. Methods: All patients admitted with ACS to our medical center, between October 7th, 2023, and January 6th, 2024, were retrospectively included. Crucial time intervals in the management of individuals with ACS were collected in a predetermined spreadsheet. In-hospital and 30-day outcomes were obtained from the medical records and contrasted with ACS cases admitted in the period preceding the war. Results: A total of 449 individuals (102 females [22.7 %]) with a diagnosis of ACS were recruited, 358 patients (144 STEMI and 214 NSTEMI) were admitted during the 9 months before October 7th and 91 patients (42 STEMI and 49 NSTEMI) in the 3 months after October 7th. Compared to the control period, a significant reduction in ACS admissions per month was noted (38.91 vs. 28.79, p < 0.001) driven by fewer cases of both STEMI and NSTEMI (15.65 vs. 13.29, p = 0.011 and 23.26 vs. 15.5, p < 0.001, respectively). In patients with STEMI, the total ischemic time was similar before and after the war (179 min vs. 187 min, p = 0.849). Conclusions: War has a dramatic impact on cardiovascular incidence and outcomes which, however, are not necessarily linked to higher admission rates. Nevertheless, with the adoption of systematic approach and increased awareness, patients with ACS can be managed effectively even at times of extremely limited resources such as war.http://www.sciencedirect.com/science/article/pii/S2405844024172039
spellingShingle Sharon Bruoha
Tatiana Stolichny
Vladimir Chitoroga
Michael Shilo
Michael Friger
Jamal Jafari
Evgeny Chernogoz
Maggie Cohen Grisaru
Amos Katz
Chaim Yosefy
Gili Givaty
The impact of war on ACS admissions and triage – a single center experience
Heliyon
title The impact of war on ACS admissions and triage – a single center experience
title_full The impact of war on ACS admissions and triage – a single center experience
title_fullStr The impact of war on ACS admissions and triage – a single center experience
title_full_unstemmed The impact of war on ACS admissions and triage – a single center experience
title_short The impact of war on ACS admissions and triage – a single center experience
title_sort impact of war on acs admissions and triage a single center experience
url http://www.sciencedirect.com/science/article/pii/S2405844024172039
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