National Efforts to Improve Door-to-Balloon Time Results From the Door-to-Balloon Alliance

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:54

Article

Bradley, Elizabeth H.¹  Nallamothu, Brahmajee K.²  Herrin, Jeph³  Ting, Henry H.⁵  Nembhard, Ingrid M.^1,6  Yuan, Christina T.¹  Green, Jeremy C.¹  Kline-Rogers, Eva⁷  Wang, Yongfei³  Curtis, Jeptha P.³  Webster, Tashonna R.^1,8  Masoudi, Frederick A.^9,10,11  Fonarow, Gregg C.¹²  Brush, John E., Jr.¹³  Krumholz, Harlan M.^1,3,4,14 

[1] Yale Univ, Sch Publ Hlth, Sect Hlth Policy & Adm, New Haven, CT USA

[2] VA Med Ctr, Hlth Serv Res & Dev Ctr Excellence, Ann Arbor, MI USA

[3] Yale Univ, Sch Med, Sect Cardiovasc Med, New Haven, CT USA

[4] Yale Univ, Sch Med, Robert Wood Johnson Clin Scholars Program, Dept Med, New Haven, CT USA

[5] Mayo Clin, Div Cardiovasc Dis, Rochester, MN USA

[6] Yale Univ, Sch Management, New Haven, CT USA

[7] Univ Michigan Hlth Syst, Div Cardiol, Dept Internal Med, Ann Arbor, MI USA

[8] Univ Connecticut, Ctr Publ Hlth & Hlth Policy, E Hartford, CT USA

[9] Univ Colorado, Div Cardiol, Dept Med, Denver Hlth Med Ctr, Denver, CO 80202 USA

[10] Univ Colorado, Colorado Hlth Outcomes Program, Dept Med, Denver, CO 80202 USA

[11] Univ Colorado, Hlth Sci Ctr, Denver, CO USA

[12] Univ Calif Los Angeles, Med Ctr, Dept Med, Los Angeles, CA 90024 USA

[13] Sentara Cardiovasc Res Inst, Norfolk, VA USA

[14] Yale New Haven Med Ctr, Ctr Outcomes Res & Evaluat, New Haven, CT 06504 USA

关键词: acute myocardial infarction;    hospitals;    quality collaborative;    quality improvement;   

DOI  :  10.1016/j.jacc.2009.11.003

来源: Elsevier

【 摘 要 】

Objectives The purpose of this study was to determine if enrollment in the Door-to-Balloon (D2B) Alliance, a national quality campaign sponsored by the American College of Cardiology and 38 partner organizations, was associated with increased likelihood of patients who received primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI) being treated within 90 min of hospital presentation. Background The D2B Alliance, launched in November 2006, sought to achieve the goal of having 75% of patients with STEMI treated within 90 min of hospital presentation. Methods We conducted a longitudinal study of D2B times in 831 hospitals participating in the National Cardiovascular Data Registry (NCDR) CathPCI Registry, April 1, 2005, to March 31, 2008. Results By March 2008, >75% of patients had D2B times of <= 90 min, compared with only about one-half of patients with D2B times within 90 min in April 2005. Trends since the launch of the D2B Alliance showed that patients treated in hospitals enrolled in the D2B Alliance for at least 3 months were significantly more likely than patients treated in nonenrolled hospitals to have D2B times within 90 min, although the magnitude of the difference was modest (odds ratio: 1.16; 95% confidence interval: 1.07 to 1.27). Conclusions The D2B Alliance reached its goal of 75% of patients with STEMI having D2B times within 90 min by 2008. (J Am Coll Cardiol 2009; 54: 2423-9) (C) 2009 by the American College of Cardiology Foundation

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