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July 25, 2020International Journal of AngiologyOpen Access

Interhospital transferred patients had longer total ischemic time (median, 465 vs. 414 minutes, p < 0.001), and delay in door-in-to-door-out time at the first hospital was strongly associated with prolonged total ischemic time (adjusted OR = 3.92; 95% CI: 3.06–5.04, p < 0.001).

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Why the study?

There is concern whether patients with STEMI admitted to a PCI center from interhospital transfer experience longer reperfusion time compared with direct admission.

Does interhospital transfer compared to direct admission increase reperfusion delays in patients with STEMI?

Population

6,494 consecutive STEMI patients admitted between 2011 and 2019

Comparison

Interhospital transfer vs direct admission

Design

Retrospective cohort study

Authors

SDSurya DharmaIDIwan DakotaHAHananto Andriantoro

Discussion

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Member takes

Overview

May warrant caution with interhospital STEMI transfers; leaves open optimal network triage strategies.

Structured PICO

Does interhospital transfer compared to direct admission increase reperfusion delays in patients with STEMI?

P
Population
6,494 consecutive patients with ST-segment elevation myocardial infarction (STEMI) admitted between 2011 and 2019.
I
Intervention
Interhospital transfer to a primary PCI center
C
Comparator
Direct admission to a primary PCI center
O
Outcome
Reperfusion delays (symptom-to-PCI center admission time, door-to-device time, and total ischemic time)surrogate

Interhospital transfer for STEMI patients is associated with longer total ischemic time driven by door-in-to-door-out delays at the first hospital, despite shorter door-to-device times at the PCI center.

Cite This Study

Dharma et al. (2020) studied this question.

synapsesocial.com/papers/6a711dcc35aa2c282ce26f8dhttps://doi.org/10.1055/s-0040-1714686
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The impact of transferring patients with ST-segment elevation myocardial infarction to percutaneous coronary intervention-capable hospitals on clinical outcomes2016 · 14 citations
  2. 2Outcome of inter-hospital transfer versus direct admission for primary percutaneous coronary intervention: An observational study of 25,315 patients with ST-elevation myocardial infarction from the London Heart Attack Group2020 · 29 citations
  3. 3Interhospital transfer due to failed prehospital diagnosis for primary percutaneous coronary intervention: an observational study on incidence, predictors, and clinical impact2013 · 46 citations
  4. 4Inter-hospital transfers and door-to-balloon times for STEMI: a single centre cohort study.2020 · 6 citations
  5. 5Inter-hospital transfer for primary angioplasty: delays are often due to diagnostic uncertainty rather than systems failure and universal time metrics may not be appropriate2015 · 14 citations