Heart Patients Transferred Too Late

Heart attack patients in need of transfers not arriving in time

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Sometimes the closest hospital doesn't offer the procedures needed to save a heart attack patient. Quick transfers to another hospital for treatment is often needed within a half an hour. Most heart attack transfers are not happening fast enough.

Just over 10 percent of patients with a particular type of heart attack in need of transfer to another hospital for procedures such as balloon angioplasty or stent placement to open narrowed coronary arteries get there within the recommended time of 30 minutes,.

The study published in the June issue of the Journal of the American Medical Association revealed substantial delays in getting patients to a second hospital for treatment.

"Get regular heart check ups to know your risks."

The study related to heart attacks for patients with ST-segment elevation myocardial infarction, which refers to a certain electrocardiogram pattern. About 75 percent of U.S. hospitals still lack acute facilities to treat the type of heart attack, and patients are frequently transferred as a result. National benchmarks suggest those transfers should occur within 30 minutes.

Dr. Tracy Y. Wang, M.D., M.H.S., M.Sc., of Duke University Medical Center, the study's lead researcher, said the median time was 68 minutes with only 11 percent receiving transfers in 30 minutes or less. In addition, 56 percent reported a transfer time of more than 60 minutes and 35 percent took longer than 90 minutes.

Characteristics associated with transfer times of more than 30 minutes included older patients, women, off-hour transfers and non-emergency transportation to the first hospital.

Patients with a transfer time of 30 minutes or less were more likely to undergo primary percutaneous coronary intervention such as balloon angioplasty after arriving at the second hospital with 96 percent versus 91 percent who arrived after more than half an hour. The time from arriving at the second hospital until receiving treatment was also shorter for those who arrived in under half an hour, with those who arrived in 30 minutes receiving treatment within 85 minutes and others receiving it at an average of 127 minutes.

During the study period, the researchers observed a 5.5 percent in-hospital mortality rate that was significantly higher among patients with a time greater than 30 minutes compared with 2.7 percent for patients who were trasnferred in 30 minutes or less.

Dr. Wang said the study said that substantial improvement in the timeliness of transfers is needed to ensure patients receive the needed heart attack therapies.

The study included data on 14,821 patients with ST-segment elevation myocardial infarction transferred to 298 receiving centers for care between January 2007 and March 2010.

Reviewed by: 
Review Date: 
June 20, 2011
Last Updated:
June 21, 2011