Sunday, January 29, 2006

Heart Attack Patients Do Best at Hospitals That Specialize

Patients are less likely to die during their hospital stay, and will receive faster treatment, if they have their emergency angioplasty at hospitals where it is the "default" treatment, used on the vast majority of heart attack patients, according to a study in the journal Circulation.

By contrast, the in-hospital death risk and risk of delayed treatment were both higher for angioplasty patients treated at hospitals where emergency angioplasty was used in a minority of heart-attack patients. On the whole, they were significantly more likely to die before leaving the hospital, and waited an average of 20 minutes longer for treatment, than those treated at hospitals where most heart attack patients received angioplasty.

Also, according to the study, it's not the number angioplasties that are performed each year that's most important, but "the overall commitment to doing emergency angioplasties, and the protocols and staffing that come out of that commitment."

"The bottom line for anyone having a heart attack," says lead author Brahmajee Nallamothu, MD, MPH, "is still to call 911 and let the emergency medical staff decide which hospital to choose.

You want the "door to balloon" time to be less than 90 minutes.

A study last year indicated that just under 50% of those whose heart attacks occurred during business hours were treated within the 90 minutes recommended by AHA. After hours, only 25% were treated that quickly. The "door to balloon" times for angioplasty patients rose from 95 minutes during business hours to 116 minutes after hours.

You may want to inquire as to whether the hospitals near your home and workplace perform emergency angioplasties within 90 minutes of arrival. Keep the list of those that do in your head. Then, perhaps, you can make suggestions to the emergency personnel as to which hospital to go to.

Contact your local hospitals.


At 4:30 PM, January 31, 2006, Anonymous Hbennett said...

A good article. However, would it be possible to post the names of the hospitals doing emergency angioplasties within the time limits prescribed (90 minutes) in the metro area, orat least Northern Va. and/or Montgomery County?

At 6:27 PM, January 31, 2006, Blogger Marcia Van Horn said...

I have been unable to locate that, but I will keep trying and let you know. I'd suggest calling a couple close to you and ask for the ER/chest pain center. They'll be proud to tell you if they are.


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