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Crowding does not adversely affect time to percutaneous coronary intervention for acute myocardial infarction in a

Ben Harris1, Jeonghwan Christian Bai, Erik B Kulstad

  • 1Department of Emergency Medicine, Advocate Christ Medical Center, Oak Lawn, IL, USA. gbenharris@gmail.com

Annals of Emergency Medicine
|August 2, 2011
PubMed

Insights

Emergency department crowding did not impact door-to-balloon times for ST-segment elevation myocardial infarction (STEMI) patients receiving percutaneous coronary intervention. Timely treatment was not significantly delayed by higher occupancy rates in this study.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Health Services Research

Background:

  • Emergency department (ED) crowding is linked to delayed patient care.
  • Timely percutaneous coronary intervention (PCI) is crucial for ST-segment elevation myocardial infarction (STEMI) outcomes.
  • The relationship between ED occupancy and PCI delays for STEMI patients requires investigation.

Purpose of the Study:

  • To determine if increased emergency department occupancy rates correlate with delays in door-to-balloon time for STEMI patients undergoing emergency PCI.
  • To analyze the impact of ED crowding on critical cardiac intervention timelines.

Main Methods:

  • A prospective observational study was conducted at a single institution.
  • Door-to-balloon times and ED occupancy rates were measured for STEMI patients undergoing PCI from June 2007 to October 2009.
  • Univariate and multivariate analyses controlled for patient characteristics and procedural factors.

Main Results:

  • A total of 210 STEMI patients underwent emergency PCI.
  • The mean ED occupancy rate was 127%, with a mean door-to-balloon time of 65 minutes.
  • Increasing occupancy rates did not significantly correlate with longer door-to-balloon times in either univariate or multivariate analyses.

Conclusions:

  • Emergency department crowding, as measured by occupancy rate, does not appear to positively correlate with delays in door-to-balloon times for STEMI patients.
  • The availability of an in-house catheterization laboratory team was associated with reduced door-to-balloon times.
Abstract

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