Hospital Arrival Time Impacts Heart Attack Outcomes
(HealthDay News) — Time of presentation to the hospital may influence treatment and mortality for patients with myocardial infarction, according to research published online July 29 in Circulation: Cardiovascular Quality and Outcomes.
Tarun W. Dasari, MD, MPH, of the Oklahoma Health Sciences Center in Oklahoma City, and colleagues examined performance measures and in-hospital mortality for individuals with ST-segment-elevation myocardial infarction (STEMI) presenting during off-hours (27,270 patients) vs. on-hours (15,972 patients).
The researchers observed no significant differences between the on-hours and off-hours group for several key performance measures in STEMI, including aspirin use (almost 99% in both groups), door-to-electrocardiogram time ≤10 minutes (73.4 and 74.3%, respectively; P=0.09), and door-to-needle time ≤30 minutes (62.3 vs. 58.7%; P=0.44). Among patients undergoing primary cutaneous intervention, those presenting during off-hours, compared with those presenting on-hours, had longer median door-to-balloon times (72 vs. 56 minutes; P<0.0001) and a lower rate of door-to-balloon time ≤90 minutes (79.2 vs. 87.8%; P<0.0001). In-hospital all-cause mortality was similar between the groups (4.2%), but risk-adjusted all-cause mortality was higher for patients presenting off-hours (odds ratio, 1.13; 95% confidence interval, 1.02–1.26).
"In contemporary community practice, achievement of quality performance measures in patients presenting with ST-segment-elevation myocardial infarction was high, regardless of time of presentation," the authors write.
One author disclosed financial ties to several pharmaceutical companies.