[Analysis on inter-hospital transfer in patients with acute myocardial infarction in Beijing].
OBJECTIVE
To examine the present situation of inter-hospital transfer and its impact on early reperfusion therapies and short-term outcomes in patients with acute ST-elevation myocardial infarction (STEMI) in Beijing.


METHODS
This cross-sectional and multicenter survey was conducted between 1 January and 31 December, 2006. A total of 789 STEMI patients admitted within 24 h of symptom onset to 19 hospitals capable of performing primary percutaneous coronary intervention (PCI) in Beijing were divided into transfer group and non-transfer group. Data were collected by structured interviews and medical records review.


RESULTS
A total of 236 STEMI patients (29.9%) experienced inter-hospital transfer. Of these, 76.7% were transferred from primary and secondary hospitals to tertiary hospitals, 22.9% were transferred from tertiary hospitals to tertiary hospitals, 67.4% were transferred from non-primary PCI centers to primary PCI centers, 32.6% were transferred from primary PCI centers to primary PCI centers. The difference of primary PCI rate (62.7% vs. 66.4%, P = 0.328) and door to balloon time (median, 132 min vs.135 min, P = 0.473) were similar between 2 groups. The symptom onset to balloon time was significantly longer in transfer group than in non-transfer group (median, 397 min vs. 246 min, P < 0.001). The in-hospital mortality was similar between 2 groups (4.7% vs.5.8%, P = 0.609).


CONCLUSIONS
The present situation of inter-hospital transfer is complicated for STEMI patients in Beijing. Inter-hospital transfer prolonged symptom onset to balloon time but did not influence primary PCI rate and door to balloon time as well as the short-term outcomes. Regional STEMI networks need to be instituted to improve therapies for STEMI patients.
Song
Li
L
28th Division, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Yan
Hong-bing
HB
Yang
Jin-gang
JG
Sun
Yi-hong
YH
Li
Chao
C
D000368:Aged; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D010360:Patient Transfer; D011379:Prognosis; D016896:Treatment Outcome