Impact of transfer for angioplasty and distance on AMI in-hospital mortality

Abstract

Background: The aim of the study was to evaluate the impact of transfer status and distance on in-hospital mortality for acute myocardial infarction (AMI) patients undergoing angioplasty on the same or next day of hospital admissionMethods: Retrospective analysis of English hospital administrative data using logistic regression modelling.Results: After risk adjustment for the patient baseline characteristics, transferred patients had a higher in-hospital mortality rate than those admitted directly to hospital for angioplasty performed on the same or next day: OR = 1.25 (95% confidence interval: 1.02–1.52), P = 0.029. There was no statistically significant increased risk of in-hospital mortality with increasing distance between home and angioplasty centre (OR = 0.98 (0.84–1.16), P = 0.842 for 6–15 km and 1.03 (0.87–1.22), P = 0.768 for >15 km when compared with < 6 km) or with increasing inter-hospital transfer distance for angioplasty (OR = 0.84 (0.55–1.29), P = 0.435 for 16–34 km and 0.88 (0.58–1.35), for > 34 km when compared with < 16 km).

Conclusions: Transfer status is associated with in-hospital mortality rate for AMI patients undergoing angioplasty on the same or next day of hospital admission. No relation between in-hospital mortality and the distance from home to angioplasty centre or inter-hospital transfer distance for angioplasty was found in these patients.

Keywords::

• Myocardial infarction
• angioplasty
• in-hospital mortality

Acknowledgements

The authors wish to thank the support of the Dr Foster Intelligence (an independent health service research organization) and Rx Foundation of Cambridge, Massachusetts, USA for the financial support through research grants. The Dr Foster Unit at Imperial is affiliated with the Centre for Patient Safety and Service Quality at Imperial College Healthcare NHS Trust, which is funded by the National Institute for Health Research. The authors are grateful for support from the National Institute for Health Research Biomedical Research Centre funding scheme.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.