Featured Research

from universities, journals, and other organizations

Health care system delay may increase risk of death for heart patients receiving reperfusion therapy

Date:
August 17, 2010
Source:
JAMA and Archives Journals
Summary:
For patients with a certain type of heart attack, delay in the time between first contact with emergency medical service to initiation of therapy such as balloon angioplasty is associated with an increased risk of death.

For patients with a certain type of heart attack, delay in the time between first contact with emergency medical service to initiation of therapy such as balloon angioplasty is associated with an increased risk of death, according to a study in the August 18 issue of JAMA.

Related Articles


Timely reperfusion therapy with either fibrinolysis (the dissolution of fibrin) or primary percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries) is recommended for patients with ST-segment elevation myocardial infarction (STEMI; a certain pattern on an electrocardiogram following a heart attack). Door-to-balloon delay has been proposed as a performance measure in triaging patients for primary PCI. "However, focusing on the time from first contact with the health care system to the initiation of reperfusion therapy (system delay) may be more relevant, because it constitutes the total time to reperfusion modifiable by the health care system. No previous studies have focused on the association between system delay and outcome in patients with STEMI treated with primary PCI," the authors write.

Christian Juhl Terkelsen, M.D., Ph.D., of Aarhus University Hospital, Aarhus, Denmark, and colleagues assessed the associations between treatment, patient, system, and door-to-balloon delays and mortality in a large group of patients with STEMI treated with primary PCI. The study included data from Danish medical registries of patients with STEMI transported by emergency medical service and treated with primary PCI from January 2002 to December 2008 at 3 high-volume PCI centers in Western Denmark. Patients (n = 6,209) underwent primary PCI within 12 hours of symptom onset. The median (midpoint) follow-up time was 3.4 years.

The researchers found that when stratified according to intervals of system delay, long-term cumulative mortality was 15.4 percent (n = 43) in patients with system delays of 0 through 60 minutes (n = 347), 23.3 percent (n = 380) in those with delays of 61 through 120 minutes (n = 2,643), 28.1 percent (n = 378) in those with delays of 121 through 180 minutes (n = 2,092), and 30.8 percent (n = 275) in those with delays of 181 through 360 minutes (n = 1,127). "In multivariate analysis adjusted for other predictors of mortality, system delay was independently associated with mortality, as was its components, prehospital system delay and door-to-balloon delay," the authors write.

"We conclude that health care system delay is valuable as a performance measure when patients with STEMI are treated with primary PCI, because it is associated with mortality, it constitutes the part of treatment delay modifiable by the health care system in the acute phase, and it applies to patients field-triaged directly to the PCI center as well as to patients transferred from local hospitals. 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."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Christian Juhl Terkelsen et al. System Delay and Mortality Among Patients With STEMI Treated With Primary Percutaneous Coronary Intervention. JAMA The Journal of the American Medical Association, 2010; 304 (7): 763 DOI: 10.1001/jama.2010.1139

Cite This Page:

JAMA and Archives Journals. "Health care system delay may increase risk of death for heart patients receiving reperfusion therapy." ScienceDaily. ScienceDaily, 17 August 2010. <www.sciencedaily.com/releases/2010/08/100817161106.htm>.
JAMA and Archives Journals. (2010, August 17). Health care system delay may increase risk of death for heart patients receiving reperfusion therapy. ScienceDaily. Retrieved October 25, 2014 from www.sciencedaily.com/releases/2010/08/100817161106.htm
JAMA and Archives Journals. "Health care system delay may increase risk of death for heart patients receiving reperfusion therapy." ScienceDaily. www.sciencedaily.com/releases/2010/08/100817161106.htm (accessed October 25, 2014).

Share This



More Health & Medicine News

Saturday, October 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins