Document Detail


In-hospital outcomes of a regional ST-segment elevation myocardial infarction acute transfer and repatriation program.
MedLine Citation:
PMID:  21803534     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) presents challenges in a large geographic area for achieving treatment time targets and creates demands on the PCI centre resources.
OBJECTIVE: We compare the in-hospital mortality rate of patients presenting with STEMI and referred for PCI from 11 transfer hospitals with those presenting to the cardiac centre in a regional STEMI program with a selective repatriation strategy.
METHODS: Between June 1, 2003, and June 30, 2007, clinical and procedural data of all STEMI patients who were referred to the catheterization laboratory were prospectively collected. Patients who sustained prolonged cardiac arrest were excluded.
RESULTS: A total of 1154 patients from regional hospitals and 325 patients initially presenting to the PCI centre were referred for acute intervention. There was no significant in-hospital mortality difference between the 2 groups (3.7% vs 4.0%, respectively; P = 0.87). Multiple logistic regression analysis showed that advanced age, female gender, multivessel coronary disease, history of hypertension, low ejection fraction, increased left ventricular end-diastolic pressure, and thrombolytic pretreatment, but not transfer status, were independent predictors for mortality. Among the 1154 transfer patients, 937 patients (81.2%) returned immediately post procedure and had a lower mortality rate than the remaining 217 patients (18.2%) who required admission to the PCI centre following cardiac catheterization (1.9% vs 11.5%, P < 0.001).
CONCLUSION: A regional system of STEMI care based on rapid patient transfer to a PCI centre and repatriation was feasible and safe.
Authors:
Albert W Chan; Shahrukh N Bakar; Robert I Brown; Robin Kuritzky; Akbar Lalani; Wendy Gordon; Carol G Laberge; Gerald J Simkus
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-07-31
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  27     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:    2011 Sep-Oct
Date Detail:
Created Date:  2011-10-03     Completed Date:  2011-12-13     Revised Date:  2012-02-28    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  664.e1-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiac Services, Royal Columbian Hospital, New Westminster, British Columbia, Canada. albert.chan@fraserhealth.ca
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary*
Electrocardiography
Feasibility Studies
Female
Hospital Mortality*
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis*,  mortality*,  therapy
Patient Transfer*
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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