Impact of Transportation Mode on ST-segment elevation myocardial infarction Outcomes in the Emergency Department: A Retrospective Single-center Study

Background: In patients with ST-segment elevation myocardial infarction (STEMI), timely management is critical in the emergency department (ED). Emergency medical services (EMS) have a pivotal role in facilitating access to care and reducing the rate of mortality among STEMI patients. Therefore, the present study aimed to evaluate the mortality rate among STEMI patients who underwent percutaneous coronary intervention (PCI) and its association with the mode of transportation. Methodology: This retrospective, cohort study included all STEMI patients who presented to the ED at King Saud University Medical City and underwent PCI from July 2020 to February 2024. Data collection focused on sociodemographic information, risk factors, comorbidities, mode of arrival, key performance indicators (KPIs), and 30-day mortality rate. Kolmogorov–Smirnov test, Mann–Whitney test, and Cox proportional hazard regression were used to examine differences in variables. P ≤ 0.05 was considered statistically significant. Results: A total of 234 STEMI patients were included, categorized based on their mode of transportation. Of these, 81 (34.6%) arrived by EMS, while 153 (65.3%) arrived by private vehicle. The 30-day mortality rate was 14.8% among EMS-transported patients compared to 5.9% in the private vehicle group. The median length of stay in the ED was 38 min (range: 15–73) for the EMS-transported group and 44 min (range: 20–77) for the private vehicle group. Conclusion: A higher mortality rate was detected among those who were transported by EMS, with higher triage levels and more comorbidities. Notwithstanding, EMS can speed time to intervention. Future efforts should focus on encouraging the utilization of EMS and investigating the risk factors that impact mortality.