Impact of a Statewide ST-Segment-Elevation Myocardial Infarction Regionalization Program on Treatment Times for Women, Minorities, and the Elderly
Impact of a Statewide ST-Segment-Elevation Myocardial Infarction Regionalization Program on Treatment Times for Women, Minorities, and the Elderly
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DOI：
10.1161/circoutcomes.109.917112
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发表时间：
2010-09-01
影响因子：
6.9
通讯作者：
Jollis, James G.
中科院分区：
文献类型：
--
作者：
Glickman, Seth W.;Granger, Christopher B.;Jollis, James G.
Background-Prior studies have demonstrated differences in time to reperfusion for ST-segment-elevation myocardial infarction (STEMI) in women, minorities, and the elderly, relative to their counterparts. Regionalization has been shown to improve overall STEMI treatment times, but its impact on care differences among these important patient subgroups is unknown. The objective of this analysis was to assess the impact of a statewide system of STEMI care (The Reperfusion of Acute Myocardial Infarction in North Carolina Emergency Departments) on treatment times according to patient sex, race, and age.Methods and Results-STEMI treatment times were determined before (July 2005 to September 2005) and after (January 2007 to March 2007) a year-long implementation of coordinated regional treatment protocols. Times in the pre- and postintervention periods were compared by mixed-effects models. A total of 2063 STEMI patients were analyzed: 1140 at percutaneous coronary intervention hospitals and 923 at non-percutaneous coronary intervention hospitals. The Reperfusion of Acute Myocardial Infarction in North Carolina Emergency Departments was associated with significant improvements in treatment times in women and the elderly, including door-to-ECG, door-to-device, door-in-door-out, and door-to-needle times (all P
