RIPAS Hospital’s DIDO time better than Canada, US

Danial Norjidi

The Emergency Department of Raja Isteri Pengiran Anak Hajah Saleha (RIPAS) Hospital recently conducted a study to look at Door In Door Out (DIDO) time – a measure of how long patients suffering heart attack stay in the Emergency Department before being transferred to Gleneagles JPMC.

According to a press release from the Brunei Cardiac Society, the study was conducted by Medical Officer at the Emergency Department of RIPAS Hospital Dr Mohammad Noh bin Haji Latip.

The study noted that heart attack or ST-Elevation Myocardial Infarction (STEMI) happens when one of the coronary arteries supplying the heart gets completely blocked. This necessitates the urgent opening (reperfusion) of the blocked artery through a procedure called primary angioplasty/stenting. This is a time sensitive procedure as the longer the time has elapsed, the higher the chance of permanent heart damage. This can also impact the patient’s long-term survival.

The press release stated that delay in reperfusion can be due to multiple factors such as, for example, delay in coming to hospital, delay in diagnosis, delay in initiating treatment etc.

“In Brunei Darussalam, primary angioplasty is performed at Gleneagles JPMC, which is the sole cardiac tertiary care centre in Brunei. This means that all patients with heart attacks to the various hospitals will be transported to Gleneagles JPMC for this vital treatment,” it was shared. “Our statistics show that a majority of these patients are referred from RIPAS Hospital.”

The American Heart Association strongly recommends a DIDO time in STEMI inter-hospital transfer to be less than 30 minutes for every non-percutaneous coronary intervention (PCI) capable centre.

“From this study, the median DIDO transfer time of 40 minutes from RIPAS Hospital Emergency Department is relatively faster when compared to other studies done in Canada and United States (US) where their median DIDO time was around 55 to 68 minutes respectively.”

“This study also found that we achieved higher percentage of patient transfer within the recommended time of less than 30 minutes (37.3 per cent of our patient transfers fell into this category). This is better than some studies in the US and the United Kingdom (UK) where only around 9.7 per cent to 14.1 per cent of patients meet the recommended DIDO time respectively,” added the press release.