AI Article Synopsis
- The study evaluates in-hospital mortality rates for STEMI patients who received primary percutaneous coronary intervention (PCI) from 11 regional hospitals versus those who presented directly to a cardiac center.
- The data collected over four years involved 1,154 transfer patients and 325 patients at the PCI center, showing no significant difference in mortality between the two groups.
- Factors like age, gender, and heart conditions were found to be key predictors of mortality, while the transfer status did not significantly impact outcomes.
Article Abstract
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.
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| http://dx.doi.org/10.1016/j.cjca.2010.12.050 | DOI Listing |
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