This article is more than 5 years old. Information may no longer be current.
Suboptimal Transfer Times Reported for Most Patients Needing PCI
Herrin J. Arch Intern Med.2011;171:1879-1886.
Redberg R. Arch Intern Med.
2011;doi:10.1001/archinternmed.2011.566.
Click Here to Manage Email Alerts
The door-in to door-out time for patients with STEMI requiring transfer to another hospital for PCI rarely met the recommended 30 minutes, according to a study published in the Archives of Internal Medicine.
The study included time-to-transfer data developed by CMS on patients (n=13,776) with STEMI who presented to EDs in 1,034 hospitals and required transfer for PCI. They defined door-in to door-out (DIDO) time as the time from patient presentation to patient discharge from the transferring hospital.
Results indicated only 9.7% of patients had a DIDO time within the recommended 30 minutes, while the time exceeded 90 minutes in 31% of cases. After multivariable analysis, times to transfer were longer for women, blacks and those at least 75 years of age. Researchers also found that only 1.3% of hospitals met the recommended DIDO time of 30 minutes or less, with the median DIDO time for all hospitals of 68 minutes.
 |
|
| Rita F. Redberg |
During their analysis, the researchers reported that many patients benefited from fibrinolytic therapy after transfer vs. primary PCI. As a result, Rita F. Redberg, MD, MSc, professor of medicine, University of California, San Francisco, and author of an accompanying editorial, said physicians should reconsider treatment strategies.
“For low- and intermediate-risk patients, there is no mortality advantage to primary PCI over thrombolytic therapy,” she wrote. “Even for high-risk patients with STEMI, the mortality benefit of primary PCI is frequently lost due to routine delays of 1 to 3 hours by transfer. It is time to reconsider transferring patients with STEMI for primary PCI. Timely reperfusion by thrombolytics, not late primary PCI via transfer, will save lives.”
Disclosure: Dr. Redberg reports no relevant financial disclosures.