Regional STEMI Transfers Can Attain 90 Minute Balloon Times
(HealthDay News) – A network approach to transfer ST-segment-elevation myocardial infarction (STEMI) patients can achieve consistent first door-to-balloon times (1st D2B) for percutaneous coronary intervention (PCI) within 90 minutes, according to a study published online Sept. 18 in the Journal of American College of Cardiology: Cardiovascular Interventions.
B. Hadley Wilson, MD, from Carolinas Medical Center in Charlotte, NC, and colleagues compared transfer STEMI patients from nine network hospitals treated in 2007 (101 patients) with 2008–2011 (442 patients) after new initiatives were undertaken. These initiatives included an established hospital referral system; goal-oriented performance protocols; expedited transport; first hospital activation of the PCI hospital catheterization laboratory; and outreach coordinator and patient-level web-based feedback.
The researchers found that after the initiatives were put in place the median door-in to door-out time decreased significantly from 44 to 35 minutes; the median 1st D2B decreased significantly from 109.5 to 88 minutes; and the percentage under 90 minutes increased significantly from 22.8% to 55.9%. Transport times remained consistent throughout the study period, whereas the PCI hospital D2B decreased significantly from 20 to 16 minutes. Length of stay and in-hospital mortality remained low.
"A system-wide network program can achieve sustained (over four years) 1st D2B times of <90 minutes," the authors write.
Several authors disclosed financial ties to the biotechnology and medical device industries.