Evaluation of a regional ST-elevation myocardial infarction primary percutaneous coronary intervention program at the Rouge Valley Health System

BMC Health Services Research

Winston W Isaac²  Candace J Ikeda-Douglas²  Robin Horodyski¹  Jodie Pritchard¹  Pria MD Nippak² 

[1] Rouge Valley Health System, 580 Harwood Avenue South, Ajax, ON L1S 2J4, Canada;Health Services Management Department, Ryerson University, 350 Victoria St, Toronto, ON M2K 5B3, Canada

关键词: Catheterization;    Myocardial infarction;    Balloon;   

Others  :  1126026
DOI  :  10.1186/1472-6963-14-449

 received in 2013-06-10, accepted in 2014-09-24,  发布年份 2014

【 摘 要 】

Background

ST-elevation myocardial infarction (STEMI) remains the second leading cause of death in Canada. Primary percutaneous coronary intervention (PCI) has been recognized as an effective method for treating STEMI. Improved access to primary PCI can be achieved through the implementation of regional PCI centres, which was the impetus for implementing the PCI program in an east Toronto hospital in 2009. As such, the purpose of this study was to measure the efficacy of this program regional expansion.

Methods

A retrospective review of 101 patients diagnosed with STEMI from May to Sept 2010 was conducted. The average door-to-balloon time for these STEMI patients was calculated and the door-to-balloon times using different methods of arrival were analyzed. Method of arrival was by one of three ways: paramedic initiated referral; patient walk-ins to PCI centre emergency department; or transfer after walk-in to community hospital emergency department.

Results

The study found that mean door-to balloon time for PCI was 112.5 minutes. When the door-to-balloon times were compared across the three arrival methods, patients who presented by paramedic-initiated referral had significantly shorter door-to-balloon times, (89.5 minutes) relative to those transferred (120.9 minutes) and those who walked into a PCI centre (126.7 minutes) (p = 0.047).

Conclusions

The findings suggest that the partnership between the hospital and its EMS partners should be continued, and paramedic initiated referral should be expanded across Canada and EMS systems where feasible, as this level of coverage does not currently exist nationwide. Investments in regional centres of excellence and the creation of EMS partnerships are needed to enhance access to primary PCI.

【 授权许可】

   
2014 Nippak et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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