Document Detail


Quality measure study: progress in reducing the door-to-balloon time in patients with ST-segment elevation myocardial infarction.
MedLine Citation:
PMID:  21229488     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Reperfusion therapy improves both mortality and morbidity in patients with ST-elevation myocardial infarction (STEMI). Timeliness of such reperfusion is an important factor in improving patient survival. For percutaneous coronary intervention (PCI), the American College of Cardiology has recommended a goal of <90 minutes from initial hospital contact to first balloon inflation.
METHODS: The authors retrospectively reviewed 131 patients with a diagnosis of STEMI seen at a PCI capable hospital between January, 2006 and September, 2008, a period of time before and after implementation of a protocol aimed at reducing door-to-balloon time. Sixty-one percent of study population was Asian or Pacific Islander. This protocol was largely based on the identification by Bradley et al. of factors whose modification could shorten this time interval.
RESULTS: Time to reperfusion was compared between groups before (n=57), and after (n=58) protocol implementation. Median door-to-balloon time for the former group was 133 minutes, interquartile range (IQRs), (25th, 75th percentile; 104.5, 147), and for the latter group 67 minutes, IQRs (56, 80) respectively (p<0.001). Prior to implementation of the protocol, a door-to-balloon time of <90 minutes was achieved in 17% of cases. By the third quarter of 2008, this goal was being met in 100%.
CONCLUSION: This observational study provides support for the use of the strategies described as a key for reduction in door-to-balloon time.
Authors:
Katsufumi Nishida; Sean K Hirota; Todd B Seto; Daniel C Smith; Cathy Young; Wanda Muranaka; Suzanne Beauvallet; David Fergusson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hawaii medical journal     Volume:  69     ISSN:  0017-8594     ISO Abbreviation:  Hawaii Med J     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2011-01-13     Completed Date:  2011-02-24     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  2984209R     Medline TA:  Hawaii Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  242-6     Citation Subset:  IM    
Copyright Information:
Hawaii Medical Journal Copyright 2010.
Affiliation:
John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96813, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary / standards*
Electrocardiography
Female
Hawaii
Humans
Male
Middle Aged
Myocardial Infarction / diagnosis,  therapy*
Quality Assurance, Health Care
Retrospective Studies
Time Factors
Comments/Corrections

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


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