title: Operator's procedure volume and not years of experience, determine needle to balloon time in primary percutaneous coronary intervention.
abstract: OBJECTIVE
  This study aimed at evaluating operator and procedural variables affecting needle to balloon time in primary percutaneous coronary intervention.
  
  
  BACKGROUND
  The relationship between operator's variables with needle to balloon time is unknown.
  
  
  METHODS
  A total of 399 consecutive patients from 06/2010 to 03/2012 presenting with ST-elevation myocardial infarction in a community medical center were included in the study. Operator experience was calculated in number of years in interventional practice and operator procedure volume in number of percutaneous coronary intervention procedures performed annually. The time of arrival was divided into regular hours (7 am to 4 pm) and off hours (4 pm to 7 am) on weekdays and the entire duration on weekends and holidays.
  
  
  RESULTS
  The average patient age was 65 years and 59% were males. The mean needle to balloon time was 18.53 ± 8 min. There was no difference in needle to balloon time between patients presenting during regular hours compared to those presenting during off hours (18.19 ± 6.88 vs. 18.93 ± 9.13, P > 0.5). Operator experience (coefficient = -0.10, P = 0.03) and procedure volume (coefficient = -0.63, P < 0.0001) showed negative correlation with needle to balloon time. In multivariate analysis after adjusting for access sites and operator experience, procedure volume was the only independent predictor of needle to balloon time (P < 0.001).
  
  
  CONCLUSIONS
  Operator procedure volume and not the years of experience, determine the needle to balloon time in patients undergoing primary percutaneous coronary intervention. Operator performance as assessed by needle to balloon time is not affected by the time of the day.
authors: The Wright Center for Graduate Medical Education, Scranton, Pennsylvania.
authors: Imdad
authors: I
authors: Ahmed
authors: Samir B
authors: SB
authors: Pancholy
mesh_terms: D039602:After-Hours Care; D000368:Aged; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D010414:Pennsylvania; D062645:Percutaneous Coronary Intervention; D010561:Personnel Staffing and Scheduling; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D061665:Time-to-Treatment; D016526:Workload
keywords: ST-elevation myocardial infarction; door to balloon time; off hours; weekends