• Am J Emerg Med · Jan 2017

    The impact of recommended percutaneous coronary intervention care on hospital outcomes for interhospital-transferred ST-segment elevation myocardial infarction patients.

    • YeongHo Choi, Yu Jin Lee, Sang Do Shin, Kyoung Jun Song, KyungWon Lee, Eui Jung Lee, Yu Jin Kim, Ki Ok Ahn, Ki Jeong Hong, and Young Sun Ro.
    • Department of Emergency Medicine, Seoul National University College of Medicine. Electronic address: d2uk87@gmail.com.
    • Am J Emerg Med. 2017 Jan 1; 35 (1): 7-12.

    BackgroundTimely transfer and percutaneous coronary intervention (PCI) with or without thrombolysis are recommended by the American Heart Association (AHA) to care for ST-segment elevation myocardial infarction (STEMI) patients who present first to a non-PCI-capable hospital. This study was to evaluate the impact on in-hospital mortality of the compliance with guidelines regarding to the time of PCI for patients with STEMI who were transferred to a capable PCI hospital.MethodsWe used the CArdioVAscular disease Surveillance data from November 2007 to December 2012 for this study. Adult patients who were diagnosed with STEMI and transferred from a primary hospital for PCI were included. Patients who underwent PCI or coronary artery bypass graft surgery in the primary hospital and patients with an unknown emergency department disposition were excluded. The main exposure was the AHA recommendation for reperfusion therapy. We tested the association between compliance with AHA and hospital mortality.ResultsA total of 2078 patients were analyzed, 30.0% of whom were treated in compliance with the guidelines, whereas the remaining 70.0% were not. Thrombolysis was performed in 7.9% and 0.8% (P value < .01) and hospital mortality was 5.0% and 6.8% (P value = .11) in the compliant and violence groups, respectively. The adjusted odds ratios (95% confidence intervals) of the compliant group for hospital mortality were 0.75 (0.46-1.21), respectively. A sensitivity analysis of symptom onset to arrival time was a trend for a beneficial effect in the compliant group.ConclusionsAmong the patients who were transferred for STEMI care, undergoing PCI as recommended by the AHA was not associated with a mortality benefit, but the patients whose symptom onset to hospital arrival time was within 30 minutes showed an association between compliance and lower mortality.Copyright © 2016 Elsevier Inc. All rights reserved.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…