title: Impact of transfer for angioplasty and distance on AMI in-hospital mortality.
abstract: BACKGROUND
  The aim of the study was to evaluate the impact of transfer status and distance on in-hospital mortality for acute myocardial infarction (AMI) patients undergoing angioplasty on the same or next day of hospital admission.
  
  
  METHODS
  Retrospective analysis of English hospital administrative data using logistic regression modelling.
  
  
  RESULTS
  After risk adjustment for the patient baseline characteristics, transferred patients had a higher in-hospital mortality rate than those admitted directly to hospital for angioplasty performed on the same or next day: OR=1.25 (95% confidence interval: 1.02-1.52), P=0.029. There was no statistically significant increased risk of in-hospital mortality with increasing distance between home and angioplasty centre (OR=0.98 (0.84-1.16), P=0.842 for 6-15 km and 1.03 (0.87-1.22), P=0.768 for >15 km when compared with <6 km) or with increasing inter-hospital transfer distance for angioplasty (OR=0.84 (0.55-1.29), P=0.435 for 16-34 km and 0.88 (0.58-1.35), for >34 km when compared with <16 km).
  
  
  CONCLUSIONS
  Transfer status is associated with in-hospital mortality rate for AMI patients undergoing angioplasty on the same or next day of hospital admission. No relation between in-hospital mortality and the distance from home to angioplasty centre or inter-hospital transfer distance for angioplasty was found in these patients.
authors.affiliation: Dr Foster Unit at Imperial College, Department of Primary Care and Public Health, School of Public Health, Imperial College London, UK. r.alexandrescu@imperial.ac.uk
authors.forename: Roxana
authors.initials: R
authors.lastname: Alexandrescu
authors.forename: Alex
authors.initials: A
authors.lastname: Bottle
authors.forename: Brian
authors.initials: B
authors.lastname: Jarman
authors.forename: Paul
authors.initials: P
authors.lastname: Aylin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000401:mortality* / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D020379:Risk Adjustment; D013222:State Medicine; D016896:Treatment Outcome; D006113:United Kingdom