August 17th, 2010

Going Beyond Door-to-Balloon by Starting Earlier

Efforts to speed delivery of PCI to STEMI patients have focused on shortening the door-to-balloon time. Now a group of Danish researchers propose that efforts to improve care must include assessment of treatment from the time of the patient’s first contact with the emergency medical system. Analyzing historical data from 6209 MI patients who received primary PCI, they found a strong relationship between system delay and long-term mortality:

  • 0-60 minute delay: 15.4% mortality
  • 61-120 minutes: 23.3% mortality
  • 121-180 minutes: 28.1% mortality
  • 181-360 minutes: 30.8% mortality

In their report in JAMA, the researchers conclude that “increased focus on the total health care system delay may optimize triage of patients with STEMI and may be the key to further improving survival of these patients.”

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