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Contact-to-balloon time and door-to-balloon time after initiation of a formalized data feedback in patients with acute ST-elevation myocardial infarction.
Am J Cardiol. 2008 Jan 01; 101(1):46-52.AJ

Abstract

For many patients with ST-segment elevation myocardial infarctions (STEMIs), the time from presentation to percutaneous coronary intervention exceeds established goals. This study was conducted to examine the effects of formalized data assessment and systematic feedback on treatment times. All patients with STEMIs treated with percutaneous coronary intervention in a semi-rural 3-hospital network from January 1, 2006, to December 31, 2006, were prospectively analyzed (n = 114). Patients presenting during the first 3-month period (January 1, 2006, to March 31, 2006) were included as the reference group (n = 33). Time points from initial contact with the medical system to revascularization were assessed, analyzed, and presented in an interactive session to hospital and emergency services staff members. Data from patients with STEMIs presenting during the next 3 quarters were presented in the same manner (n = 28, 25, and 28). The median contact-to-balloon time was 113 minutes in the reference quarter, decreasing to 83, 66, and 74 minutes in the intervention groups (p <0.0001), whereas the median door-to-balloon time decreased from 54 minutes in the reference group to 35, 31, and 26 minutes in the intervention groups (p <0.0001). The proportion of patients with contact-to-balloon times <90 minutes increased from 21% to 79% (p <0.0001). There were significant reductions in the durations of initial treatment on location and in the emergency room and in puncture-to-balloon-time in the catheterization laboratory, and more patients were transported directly to the catheterization laboratory, bypassing the emergency room (from 23% in the reference quarter to 76% in the last intervention quarter, p <0.0001). In conclusion, formalized data feedback leads to marked reduction in revascularization times in patients with STEMIs.

Authors+Show Affiliations

Department of Cardiology, St. Bernward Hospital, Hildesheim, Germany. prof.dr.k.scholz@bernward-khs.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18157964

Citation

Scholz, Karl Heinrich, et al. "Contact-to-balloon Time and Door-to-balloon Time After Initiation of a Formalized Data Feedback in Patients With Acute ST-elevation Myocardial Infarction." The American Journal of Cardiology, vol. 101, no. 1, 2008, pp. 46-52.
Scholz KH, Hilgers R, Ahlersmann D, et al. Contact-to-balloon time and door-to-balloon time after initiation of a formalized data feedback in patients with acute ST-elevation myocardial infarction. Am J Cardiol. 2008;101(1):46-52.
Scholz, K. H., Hilgers, R., Ahlersmann, D., Duwald, H., Nitsche, R., von Knobelsdorff, G., Volger, B., Möller, K., & Keating, F. K. (2008). Contact-to-balloon time and door-to-balloon time after initiation of a formalized data feedback in patients with acute ST-elevation myocardial infarction. The American Journal of Cardiology, 101(1), 46-52.
Scholz KH, et al. Contact-to-balloon Time and Door-to-balloon Time After Initiation of a Formalized Data Feedback in Patients With Acute ST-elevation Myocardial Infarction. Am J Cardiol. 2008 Jan 1;101(1):46-52. PubMed PMID: 18157964.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contact-to-balloon time and door-to-balloon time after initiation of a formalized data feedback in patients with acute ST-elevation myocardial infarction. AU - Scholz,Karl Heinrich, AU - Hilgers,Reinhard, AU - Ahlersmann,Dorothe, AU - Duwald,Holger, AU - Nitsche,Rolf, AU - von Knobelsdorff,Georg, AU - Volger,Berthold, AU - Möller,Karsten, AU - Keating,Friederike K, Y1 - 2007/11/19/ PY - 2007/05/30/received PY - 2007/07/13/revised PY - 2007/07/13/accepted PY - 2007/12/26/pubmed PY - 2008/2/7/medline PY - 2007/12/26/entrez SP - 46 EP - 52 JF - The American journal of cardiology JO - Am J Cardiol VL - 101 IS - 1 N2 - For many patients with ST-segment elevation myocardial infarctions (STEMIs), the time from presentation to percutaneous coronary intervention exceeds established goals. This study was conducted to examine the effects of formalized data assessment and systematic feedback on treatment times. All patients with STEMIs treated with percutaneous coronary intervention in a semi-rural 3-hospital network from January 1, 2006, to December 31, 2006, were prospectively analyzed (n = 114). Patients presenting during the first 3-month period (January 1, 2006, to March 31, 2006) were included as the reference group (n = 33). Time points from initial contact with the medical system to revascularization were assessed, analyzed, and presented in an interactive session to hospital and emergency services staff members. Data from patients with STEMIs presenting during the next 3 quarters were presented in the same manner (n = 28, 25, and 28). The median contact-to-balloon time was 113 minutes in the reference quarter, decreasing to 83, 66, and 74 minutes in the intervention groups (p <0.0001), whereas the median door-to-balloon time decreased from 54 minutes in the reference group to 35, 31, and 26 minutes in the intervention groups (p <0.0001). The proportion of patients with contact-to-balloon times <90 minutes increased from 21% to 79% (p <0.0001). There were significant reductions in the durations of initial treatment on location and in the emergency room and in puncture-to-balloon-time in the catheterization laboratory, and more patients were transported directly to the catheterization laboratory, bypassing the emergency room (from 23% in the reference quarter to 76% in the last intervention quarter, p <0.0001). In conclusion, formalized data feedback leads to marked reduction in revascularization times in patients with STEMIs. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/18157964/Contact_to_balloon_time_and_door_to_balloon_time_after_initiation_of_a_formalized_data_feedback_in_patients_with_acute_ST_elevation_myocardial_infarction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(07)01829-2 DB - PRIME DP - Unbound Medicine ER -