title: Process factors affecting door to percutaneous coronary intervention for acute myocardial infarction patients.
abstract: The purpose of this cross-sectional study was to identify key predictor variables with the most impact on door-to-balloon time for acute myocardial infarction patients. The authors examined arrival, process, and patient-related variables from retrospective data from calendar years 2006 and 2007 within a single community hospital (N = 273). The door-to-balloon time ranged from 28 to 167 minutes, with an average of 76.77 (standard deviation ±24.5) minutes. Key predictor variables identified through multivariate linear regression included portable chest X-ray, presentation from walk-in versus ambulance, responding cardiology group, emergency department (ED) time of arrival (day 8 AM to 5 PM or night 5 PM to 8 AM), ED day of arrival (weekday or weekend), if a code R was called prior to arrival, and if the patient was identified as having chest pain on admission to the ED. For patients with acute myocardial infarction at a single study site, the authors identified a number of key factors that delay prompt reperfusion.
authors.affiliation: Lancaster General Research Institute, Lancaster General Hospital, PA 17604, USA. mahorst@lghealth.org
authors.forename: Michael A
authors.initials: MA
authors.lastname: Horst
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Stuart
authors.forename: Nichole
authors.initials: N
authors.lastname: McKinsey
authors.forename: Angela S
authors.initials: AS
authors.lastname: Gambler
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006764:Hospitals, Community / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D017064:Process Assessment, Health Care / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000458:organization & administration*; D012189:Retrospective Studies; D013997:Time Factors; D014505:Urban Population