[Analysis on inter-hospital transfer in patients with acute myocardial infarction in Beijing].

OBJECTIVE

To examine the present situation of inter-hospital transfer and its impact on early reperfusion therapies and short-term outcomes in patients with acute ST-elevation myocardial infarction (STEMI) in Beijing.

METHODS

This cross-sectional and multicenter survey was conducted between 1 January and 31 December, 2006. A total of 789 STEMI patients admitted within 24 h of symptom onset to 19 hospitals capable of performing primary percutaneous coronary intervention (PCI) in Beijing were divided into transfer group and non-transfer group. Data were collected by structured interviews and medical records review.

RESULTS

A total of 236 STEMI patients (29.9%) experienced inter-hospital transfer. Of these, 76.7% were transferred from primary and secondary hospitals to tertiary hospitals, 22.9% were transferred from tertiary hospitals to tertiary hospitals, 67.4% were transferred from non-primary PCI centers to primary PCI centers, 32.6% were transferred from primary PCI centers to primary PCI centers. The difference of primary PCI rate (62.7% vs. 66.4%, P = 0.328) and door to balloon time (median, 132 min vs.135 min, P = 0.473) were similar between 2 groups. The symptom onset to balloon time was significantly longer in transfer group than in non-transfer group (median, 397 min vs. 246 min, P < 0.001). The in-hospital mortality was similar between 2 groups (4.7% vs.5.8%, P = 0.609).

CONCLUSIONS

The present situation of inter-hospital transfer is complicated for STEMI patients in Beijing. Inter-hospital transfer prolonged symptom onset to balloon time but did not influence primary PCI rate and door to balloon time as well as the short-term outcomes. Regional STEMI networks need to be instituted to improve therapies for STEMI patients.