Study: Most Heart Attack Hospital Transfers Delayed

There is a significantly higher mortality risk associated with the time heart attack patients spend in a hospital before they are transferred to another hospital able to perform a PCI, researchers from the Duke Clinical Research Institute have found.

In the study -- which was published this month in the Journal of the American Medical Association -- one in 10 patients who experience a major heart attack are transferred to another hospital to get necessary treatment within the recommended 30 minutes.

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Percutaneous coronary intervention is the preferred treatment for many heart attack patients, yet approximately 75 percent of hospitals in the U.S. currently do not have around-the-clock capability.

"Door-in-door-out time is a new performance measure that assesses the timeliness of care patients receive at the first hospital and the recommended time frame is less than 30 minutes," the study's lead author Tracey Y. Wang, MD said in a statement. "Until now, little had been known about this critical step in the care of these patients in need of urgent treatment. We were surprised to learn that so much valuable time is being lost."

The study included 14,821 heart attack patients who were transferred into 298 hospitals for PCI between January 2007 and March 2010.

While Wang said there has been an improvement in "door-in-door-out" time, only 11 percent of patients left the referral hospital within the recommended 30 minutes and more than one-third of patients waited more than 90 minutes.

"The majority of these waiting patients may be eligible for alternative treatment, such as fibrinolysis, a 'clot-busting' medication used to open up blocked arteries, which can be delivered at the referral hospital," she said. "Although PCI is the preferred treatment, if we know we cannot get a patient to PCI within 90 minutes, fibrinolysis should be considered in some of these patients."