Key result
Among 141 patients with STEMI undergoing inter-facility transfer, mean door-to-ECG time was 8 minutes, DIDO time was 32.5 minutes, and door-to-balloon time was 90 minutes.
Why the study?
Outcomes for STEMI patients transferred for PCI relate strongly to clinical factors and timeline intervals, prompting an evaluation of inter-facility transfer characteristics and timings between institutions in Bahrain.
Observational (n=141)
Yes
Inter-facility transfer times for STEMI patients in Bahrain met recommended targets, demonstrating the utility of an established STEMI network.
Supports STEMI network feasibility for timely transfers; leaves open generalizability and outcome impact beyond this cohort.
Background: The outcomes of patients with ST-elevation myocardial infarction (STEMI) transferred to percutaneous coronary intervention (PCI) facility is strongly related to certain demographic and clinical factors, important timelines, door-to-electrocardiography (ECG) time, door-in door-out (DIDO) time, door to balloon time (DTBT), the use of emergency medical services (EMS), and the existence of a STEMI network. In the study, we examined the inter-facility transfer for patients with STEMI analyzing certain characteristics and timings between the involved institutions. Method: This was a retrospective observational study on the inter-facility transfer of patients with STEMI admitted between January 01, 2018, and December 31, 2019. The electronic medical records of both the institutions were used to collect data on patient demographics, clinical characteristics and scores, ECG manifestations, laboratory values, treatment interventions, and outcomes with a major focus on the timelines for door-to-ECG, DIDO, and DTBT. Results: A total of 141 patients with STEMI who were transferred to a PCI center were included in this study. Their mean age was 52.26 ± 12.45 years and were mainly men (87.9%, p < 0.001). Men developed STEMI at a younger mean age (53.15 ± 12.53 years, p = 0.003). Chest pain was the most common notable symptom (129, 91.5%). Diabetes mellitus (DM) and hypertension were noted to be the comorbid factors in a majority of patients (70, 49.6%). Only 47 patients (33.3%, p < 0.001) were brought by EMS. Mean door-to-ECG and DIDO times were 8 minutes (IQR: 4–12) and 32.5 minutes (IQR: 24–46), respectively. Only 112 patients (79.4%) underwent PCI on arrival with a DTBT of 90 minutes (IQR: 70.5–105). Only door-to-ECG time and DTBT could be attained as required in this study ( p < 0.001). Conclusion: This study reveals a few beneficial statistics for the inter-facility transfer of patients with STEMI concerning their demographics, clinical characteristics, and important timelines. The door-to-ECG time, DTBT, and DIDO time were in the considerable recommended time, and this reflects the importance of establishing a STEMI network.
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Abuzeyad et al. (2022) conducted an observational in STEMI (n=141). Inter-facility transfer to a PCI center was evaluated on Timelines for door-to-ECG, DIDO, and DTBT. Among 141 patients with STEMI undergoing inter-facility transfer, mean door-to-ECG time was 8 minutes, DIDO time was 32.5 minutes, and door-to-balloon time was 90 minutes.
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