Did inter-hospital transfer reduce mortality in patients with acute myocardial infarction in the real world? A nationwide patient cohort study

Kim, Mi Sook; Choi, Seung Kang; Bae, Jang Whan; Lee, Joongyub; Kim, Hyeong-Su; Lee, Won Kyung

doi:10.1371/journal.pone.0255839

Cited by 3 publications

(2 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most studies have shown the effect of prehospital STEMI transfer to a PCI-equipped center. A recent study done by Kim et al [28] showed the effect of inter-hospital transfer in acute myocaridal infarction patients. This study used the same database (NIS multi-year database 2008-2018).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

ST elevation myocardial infarction – national trend analysis with mortality differences in outcomes based on day of hospitalization

Jha

Ojha

Bhattad

et al. 2022

Coronary Artery Disease

View full text Add to dashboard Cite

Background Patientswho present with acute ST elevation myocardial infarction (STEMI) need emergent revascularization. Our study aims to investigate the outcomes in patients with STEMI admitted during weekends versus weekdays. Methods We conducted a retrospective analysis of the nationwide inpatient sample database. Patients with an admitting diagnosis of STEMI identified by the International Classification of Disease code for the year 2016 were analyzed. A weighted descriptive analysis was performed to generate national estimates. Patients admitted over the weekend were compared to those admitted over the weekday. Patients were stratified by demographic and clinical factors including the Elixhauser comorbidity index. The primary outcome was in-hospital mortality and secondary outcomes were percutaneous coronary intervention (PCI) utilization rate, rate of transfer-out, length of stay (LOS), and total hospital charges. Statistical analysis including linear and logistic regression was performed using STATA. Results A total of 163 715 adult patients were admitted with STEMI, of which 27.9% (45 635) were admitted over the weekend. There were 76.2% Caucasians, 9.3% African Americans, and 8.0% Hispanics. Mean age of the patients was 63.2 years (95% CI, 62.9–63.5) for the weekend group and 63.7 years (95% CI, 63.5–63.9) for weekday admissions. The majority of the patients in both groups had Medicare (43.7% and 45.8% on weekends and weekdays, respectively; P = 0.0047). After adjusting for age, sex, race, income, Elixhauser comorbidity index, PCI use, hospital location, teaching status, and bed size, mortality was not significantly different in weekend versus weekday admissions (odds ratios 1.04; P = 0.498; 95% CI, 0.93–1.16). There was no significant difference in mean total charge per admission during the weekend versus weekday admissions ($107 093 versus $106 869; P = 0.99.) Mean LOS was 4.1 days for both groups (P = 0.81). Conclusions There were no significant differences in mortality, LOS, or total hospital charge in STEMI patients being admitted during the weekend versus weekdays.

show abstract

Section: Discussionmentioning

confidence: 99%

“…A recent study done by Kim et al . [28] showed the effect of inter-hospital transfer in acute myocaridal infarction patients. This study used the same database (NIS multi-year database 2008–2018).…”

Section: Discussionmentioning

confidence: 99%

ST elevation myocardial infarction – national trend analysis with mortality differences in outcomes based on day of hospitalization

Jha

Ojha

Bhattad

et al. 2022

Coronary Artery Disease

View full text Add to dashboard Cite

show abstract

Interhospital transfer among US veterans admitted to community and veterans affairs hospitals for acute myocardial infarction and ischemic stroke before and during the COVID‐19 pandemic

Vaughan‐Sarrazin,

Miell,

Beck

et al. 2024

Journal of Hospital Medicine

View full text Add to dashboard Cite

BackgroundVeterans Health Administration (VHA) enrollees may use community hospitals for inpatient care and sometimes require transfer to larger community or VHA hospitals. Little is known about interhospital transfer patterns among veterans using community and VHA hospitals or how coronavirus disease 2019 (COVID‐19) case surges affected transfer.MethodsRetrospective cohort study among veterans age 65+ admitted to community and VHA hospitals for acute myocardial infarction (AMI) or acute ischemic stroke (AIS) during 2018–2021. We examined associations between COVID‐19 case density in regional hospital referral networks and the likelihood of transfer.ResultsA total of 8373 (23.6%) veterans with AMI and 4630 (13.1%) with AIS were transferred in the prepandemic period. Transfer was especially common for rural veterans (36% with AMI, 20% with AIS). Most transfers (88%) were between community hospitals and 6% from community to VHA. Among AMI patients, transfer was less likely among patients age >90 (relative to age 65–69), those with non‐White race/ethnicity, and females. Transfer was more common among patients initially seen in rural hospitals (AMI, odds ratio [OR] = 2.73, 95% confidence interval [CI], 2.90–3.74; AIS, OR = 2.43; 95% CI, 2.24–2.65). During 2020–2021, transfer among AMI patients was less likely during COVID‐19 case density surges affecting the admitting hospital's referral network (OR = 0.86; 95% CI, 0.78–0.96 for highest compared with lowest quartile of COVID‐19 cases).ConclusionInterhospital transfer was common for veterans with AMI and AIS, especially among rural veterans. Few transfers were to VHA hospitals. COVID‐19 case surges were associated with decreased transfer for veterans with AMI, potentially limiting access to needed care.

show abstract

Analysis of Interhospital Emergency Referrals Despite Safety Concerns on the Roads: Emergency Referrals in Northwest Syria intraregional Borders

Karaca,

Çelik

2024

Anatolian Journal of Emergency Medicine

View full text Add to dashboard Cite

Aim: Our study aims to assess emergency patient transport between hospitals in the northwestern region of Syria. In this way, determining the patient profiles transferred in the region can help shed light on the reasons for avoidable transfers, reduce transfers, and reduce the risks associated with transfers. Material and Methods: Our retrospective study investigated the patients who were transferred to Azez Vatan Hospital, Çobanbey Hospital, and Jarablus Hospital and from these facilities within the borders of the northwestern region of Syria between 01/01/2020-01/01/2021. Transfer records of patients transferred between hospitals and ambulance stations were searched in files and computer records. Because there was no automation system in the healthcare facilities involved in the study, data were recorded manually on the data collection form and processed for statistical analysis. Statistical analyses of the study were performed as descriptive statistics of variables are reported as mean±standard deviation, median (min-max), and n (%). Statistical analyses of categorical variables were performed using the chi-square test and Fisher Freeman Halton Exact test. Results: The mean age of the patients of 899 patients included in the study was 33.68±26.80 years, 530(59.0%) were male and 369(41.0%) were female. 27.3% of patients were trauma patients and of both sexes. Male trauma patients were approximately 2.5 times more common than female trauma patients. Among pediatric transfers, trauma was present in one out of every three patients. Patients were most frequently transferred in February, March, and June and least frequently in January (p < 0.05). It was found that the need for adult, newborn, and pediatric intensive care, the need for medical material and equipment, the need for further examination/treatment, followed by the need for treatment under the supervision neurosurgeon, obstetric and gynecologist, cardiology specialist, or pediatrician. It was also noted that transfers for COVID-19 (SARS-CoV-2 Coronavirus Disease 2019) service needs due to the impact of the COVID-19 outbreak during the study period were among the most common reasons. COVID-19 falls, respiratory distress, traffic accidents, and acute MI were the most common diagnoses in all transferred age groups. Conclusion: In northwestern Syria, emergency patients are most often transferred from one hospital to another because they require all types of intensive care units, medical materials and equipment, advanced diagnostic treatment, and specialists in neurosurgery, obstetrics and gynecology, cardiology, and pediatrics. Increasing hospital capacity and qualifications of hospitals within the humanitarian response and increasing the number of specialists, may be considered to reduce inter-hospital transfers of emergency patients.

show abstract

Did inter-hospital transfer reduce mortality in patients with acute myocardial infarction in the real world? A nationwide patient cohort study

Cited by 3 publications

References 25 publications

ST elevation myocardial infarction – national trend analysis with mortality differences in outcomes based on day of hospitalization

ST elevation myocardial infarction – national trend analysis with mortality differences in outcomes based on day of hospitalization

Interhospital transfer among US veterans admitted to community and veterans affairs hospitals for acute myocardial infarction and ischemic stroke before and during the COVID‐19 pandemic

Analysis of Interhospital Emergency Referrals Despite Safety Concerns on the Roads: Emergency Referrals in Northwest Syria intraregional Borders

Contact Info

Product

Resources

About