Onset‐to‐device time of patients who arrive at off‐hours: Importance of prehospital management and public awareness for patients with <scp>ST</scp>‐segment elevation myocardial infarction

Mizuguchi, Yukio; Shibutani, Hiroki; Hashimoto, Shingo; Yamada, Takeshi; Taniguchi, Nobuyuki; Nakajima, Shinichi; Hata, Tetsuya; Takahashi, Akihiko

doi:10.1111/1755-5922.12227

Cited by 5 publications

(1 citation statement)

References 20 publications

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“…The dilemma is further complicated because some evidence suggests that total ischemic time, may be longer in subjects who arrive at the pPCI-capable hospitals over on-hours than those presented during off-hours. This could be due to low traffic load in off-hours during transfer of patients from other non-pPCI-capable facilities [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Association Between Off-Hour Presentations And In-Hospital Mortality For Patients With Acute ST-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Javanshir¹,

Ramandi²,

Ghaffari³

et al. 2020

Journal of the Saudi Heart Association

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Objectives This study aimed to assess the effect of the admission time (on-hours versus off-hours) on in-hospital mortality in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI) in a region without STEMI network. Methods We analysed in-hospital the mortality among 300 consecutive ST-segment elevation myocardial infarction (STEMI) patients treated with PPCI between March 2012 and February 2017. Patients were divided according to admission time into on-hours admission (08:00 AM until 08:00 PM on weekdays) versus off-hours admission (08:00 PM until 08:00 AM on weekdays and 24 h on weekends and holidays). Demographic and clinical data as well as in-hospital mortality were compared between the two groups. Results One hundred and seventy eight (59.3%) patients were admitted during on-hours, and 122 (40.7%) patients were presented in off-hours. The mean door-to-balloon time was 42.3 min in the off-hours group and 34.2 min in the on-hours group with no statistically significant difference (p = 0.39). The mortality rate was 3.9% at on-hours presentation versus 4.09% in off-hours admission (p = 0.58). Multivariate logistic regression analysis showed that off-hours presentation was not associated with in-hospital mortality. [odds ratio (OR) 0.74; 95% CI, 0.21–2.61, p = 0.64]. Conclusion Despite no efficient STEMI network in present study, off-hour presentation had no significant impact on in-hospital prognosis in patients with STEMI treated with PPCI. Larger studies are warranted in order to determine the prognostic role of off-hour presentation in patients with STEMI undergoing PPCI.

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Section: Introductionmentioning

confidence: 99%

Association Between Off-Hour Presentations And In-Hospital Mortality For Patients With Acute ST-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Javanshir¹,

Ramandi²,

Ghaffari³

et al. 2020

Journal of the Saudi Heart Association

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Impact of shorter door-to-balloon time on prognosis of patients with STEMI—single-center analysis with a large proportion of the patients treated within 30 min

Yamada

Takahashi

Mizuguchi

et al. 2018

Cardiovasc Interv and Ther

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Several recent studies suggested that the door-to-balloon time (DTBT) for patients with ST-segment elevation myocardial infarction (STEMI) should be as short as possible, despite the existing guideline for STEMI. This study aimed to evaluate the clinical outcomes of the STEMI patient cohort having the highest proportion of patients treated with a DTBT of ≤ 30 min ever reported. We evaluated 527 consecutive patients with STEMI who underwent percutaneous coronary intervention between 2007 and 2015. The mean age was 68.0 ± 12.7 years, and the mean DTBT was 44.4 ± 33.1 min. The patients were classified into four groups according to the DTBT, and the relationship between the DTBT and clinical outcome was investigated. DTBTs were ≤ 30 min in 146 patients (27.7%), 31-60 min in 297 patients (56.4%), 61-90 min in 60 patients (11.4%), and > 90 min in 24 patients (4.6%). In-hospital mortality rates were 0.7, 5.0, 11.7, and 12.5% for DTBTs of ≤ 30, 31-60, 61-90, and > 90 min, respectively. In multivariate analysis, a DTBT ≤ 30 min (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.01-0.91, p = 0.041), shock on arrival (OR 2.74, 95% CI 1.02-7.37, p = 0.046), and blood transfusion (OR 49.60, 95% CI 13.90-177.00, p < 0.001) were the independent predictors of in-hospital mortality. Patients with STEMI treated with a DTBT ≤ 30 min showed significantly better clinical outcomes than those treated with a DTBT > 30 min.

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Effect of Admission and Onset Time on the Prognosis of Patients With Cardiogenic Shock

Behnes¹,

Rusnak²,

Egner-Walter³

et al. 2024

CHEST

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Onset‐to‐device time of patients who arrive at off‐hours: Importance of prehospital management and public awareness for patients with ST‐segment elevation myocardial infarction

Abstract: The OTD time might be markedly longer in STEMI patients who arrive at the hospital during on-hours than in those who arrive at the hospital during off-hours because of the underuse of emergency medical services at STEMI onset.

Cited by 5 publications

References 20 publications

Association Between Off-Hour Presentations And In-Hospital Mortality For Patients With Acute ST-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Association Between Off-Hour Presentations And In-Hospital Mortality For Patients With Acute ST-Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Impact of shorter door-to-balloon time on prognosis of patients with STEMI—single-center analysis with a large proportion of the patients treated within 30 min

Effect of Admission and Onset Time on the Prognosis of Patients With Cardiogenic Shock

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