Mortality Risk in STEMI Patients Linked to Slow Transfers

"However, I think we still have a long way to go," she said.

The study represented hospitals in all states except Alaska, and included small rural hospitals as well as large urban acute care facilities. It included patients who arrived at the hospital by paramedic transport as well as patients who arrived by car and had to be transferred by ambulance to the second hospital.

An important finding in the study was that older, sicker patients – those who need faster catheterization procedures the most – waited longer to be transferred than younger healthier patients. Yang said that may have been because they may not have been stable enough for transfer.

The issue of hospital-to-hospital transfer of heart attack patients for appropriate catheterization is an emotionally charged one among emergency physicians and cardiologists around the country, especially in areas that lack ambulances equipped with 12-lead EKG machines that can distinguish chest pain patients that are having a true STEMI.

The practice throughout the country where there are no STEMI receiving centers is for ambulances to take patients to the closest hospital first for diagnosis and triage, rather than to one with a certified, round-the-clock catheterization lab with qualified board-certified interventional cardiologists.

Yang and co-authors wrote that their study "is the first to our knowledge to show a significantly higher mortality risk associated with a DIDO time greater than 30 minutes that persists after adjusting for many of the clinical and presenting features that contribute to myocardial infarction mortality risk."