title: Recording of quality indicators in the management of acute coronary syndromes: predictors of reperfusion times.
abstract: BACKGROUND
  There is wide variation in recording of reperfusion times in the management of ST segment elevation acute coronary syndromes (ACS). We investigated factors that could predict time to reperfusion.
  
  
  METHODS
  Single-centre, retrospective study of all consecutive patients admitted for primary PCI from June 2009 to October 2010. Door-to-artery (D2A) and Door-to-balloon (D2B) times were calculated from times noted by cathlab. nurses and compared with times from digital recordings of PCI procedures. Predictors of time to reperfusion were identified by logistic regression.
  
  
  RESULTS
  300 patients were included. Median (interquartile range) D2B time recorded by cathlab. nurses (D2B-CN) was 35.5 (24; 52) minutes, 32 (20; 51) min from PCI recordings (D2B-PCI). Average difference between D2B-CN and D2B-PCI was 6.2 min (P < 0.0001). Concordance of percent patients with a D2B time < 90 and < 45 min was mediocre, kappa coefficients 0.44 (95% CI: 0.10-0.79) and 0.68 (95% CI: 0.57-0.80) respectively. By multivariate analysis, older patients had longest D2A times (P = 0.04); patients with longest D2A and D2B times more frequently had elevated creatinine (P = 0.002 (D2A), P = 0.0003 (D2B). Organizational aspects did not influence reperfusion times.
  
  
  CONCLUSIONS
  Data regarding reperfusion times are unreliable when recorded by nurses. Age and creatinine levels are significantly associated with reperfusion times, whereas organizational aspects are not.
authors: Department of Cardiology, University Hospital J Minjoz, Besancon, France.
authors: Philoktimon
authors: P
authors: Plastaras
authors: Romain
authors: R
authors: Chopard
authors: Sebastien
authors: S
authors: Janin
authors: Marie-France
authors: MF
authors: Seronde
authors: Nicolas
authors: N
authors: Meneveau
authors: Francois
authors: F
authors: Schiele
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D019985:Benchmarking; D004638:Emergency Treatment / Q000592:standards* / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015425:Myocardial Reperfusion / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors