Heart attack patients less likely to survive when transfers exceed 30 minutes

When racing against the clock, time and treatment of are the essence. Unfortunately, the average time a heart attack patient waits to be transferred from one hospital to another is an hour, that is, 30 minutes more than the recommended wait time, according to a new study published in The Journal of the American Medical Association (JAMA). Only one in 10 major heart attack patients (11 percent) are transferred within 30 minutes to facilities that can accommodate percutaneous coronary intervention, a procedure that is available in only a quarter of U.S. hospitals, according to a Duke Health news brief released yesterday.

"Until now, little had been known about this critical step in the care of these patients in need of urgent treatment. We were surprised to learn that so much valuable time is being lost," said lead author Tracy Y. Wang, MD, assistant professor of medicine at Duke, in the news brief.

The Duke Clinical Research Institute looked at nearly 15,000 ST-segment elevation myocardial infarction patients, which is one of the most serious heart conditions. It found that increased transfer wait time also resulted in a higher risk of death. For instance, patients whose door-in, door-out time (duration from the arrival time to discharge) was 30 minutes or less had a mortality rate of 2.7 percent. That percentage more than doubled to 5.9 percent when the door-in, door-out time was more than 30 minutes, according to the study.

In addition to other measures, hospitals increasingly look at quality data including mortality rates to evaluate their institution and physician performance.

For more:
- read the JAMA study
- read the Duke Health news brief

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