Key result
Inter-hospital transfer for early angioplasty in AMI linked to ~25% higher in-hospital mortality vs. direct admission.
Why the study?
The impact of transfer status and distance on in-hospital mortality for AMI patients undergoing angioplasty on the same or next day of admission was unclear.
Observational
Yes
May warrant caution with AMI transfers but should not change practice; leaves open whether bias or delays explain the association.
BACKGROUND: The aim of the study was to evaluate the impact of transfer status and distance on in-hospital mortality for acute myocardial infarction (AMI) patients undergoing angioplasty on the same or next day of hospital admission. METHODS: Retrospective analysis of English hospital administrative data using logistic regression modelling. RESULTS: After risk adjustment for the patient baseline characteristics, transferred patients had a higher in-hospital mortality rate than those admitted directly to hospital for angioplasty performed on the same or next day: OR=1.25 (95% confidence interval: 1.02-1.52), P=0.029. There was no statistically significant increased risk of in-hospital mortality with increasing distance between home and angioplasty centre (OR=0.98 (0.84-1.16), P=0.842 for 6-15 km and 1.03 (0.87-1.22), P=0.768 for >15 km when compared with <6 km) or with increasing inter-hospital transfer distance for angioplasty (OR=0.84 (0.55-1.29), P=0.435 for 16-34 km and 0.88 (0.58-1.35), for >34 km when compared with <16 km). CONCLUSIONS: Transfer status is associated with in-hospital mortality rate for AMI patients undergoing angioplasty on the same or next day of hospital admission. No relation between in-hospital mortality and the distance from home to angioplasty centre or inter-hospital transfer distance for angioplasty was found in these patients.
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Alexandrescu et al. (2012) conducted an observational in Acute myocardial infarction (AMI). Inter-hospital transfer vs. Direct hospital admission was evaluated on In-hospital mortality (OR 1.25, 95% CI 1.02-1.52, p=0.029). Inter-hospital transfer for early angioplasty in AMI patients was associated with higher in-hospital mortality compared to direct admission (OR 1.25; 95% CI 1.02-1.52; P=0.029).
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