kerr-calltoneedletimes-2003.pdf (320.04 kB)
Call-to-needle times for thrombolysis in acute myocardial infarction in Victoria
journal contribution
posted on 2003-04-21, 00:00 authored by A-M Kelly, Debra KerrDebra Kerr, I Patrick, T WalkerOBJECTIVE: To determine the proportion of patients in Victoria treated within the British Heart Foundation 90-minute call-to-needle (CTN) time benchmark for thrombolysis of ST-elevation myocardial infarction (STEMI), and to validate the British Heart Foundation 90-minute benchmark with respect to mortality. DESIGN: Cohort study. SETTING: 20 hospitals and two ambulance services in the State of Victoria, Australia. PARTICIPANTS: 1147 patients with STEMI transported to hospital by ambulance and eligible for thrombolysis. MAIN OUTCOME MEASURES: CTN time, and in-hospital mortality. RESULTS: Median CTN time was 83 minutes (mean, 93.2 min; range, 29-894 min). Median door-to-needle (DTN) time was 37 minutes (mean, 46.5 min; range, 0-853 min). 61% of patients received thrombolysis within the 90-minute benchmark. Patients with CTN times > 90 minutes had an increased risk of dying (relative risk, 1.8; 95% CI, 1.3-2.7). Factors associated with CTN time < 90 minutes were lower DTN time, prior notification of the receiving hospital and transport time less than 20 minutes. CONCLUSION: The British Heart Foundation CTN time benchmark is being met for 61% of eligible STEMI patients in Victoria. Strategies to reduce CTN time should be region-specific, and should include attempts to reduce DTN and to enhance ambulance-hospital communication. Prehospital thrombolysis may be appropriate for some regions.
History
Journal
Medical journal of AustraliaVolume
178Issue
8Pagination
381 - 385Publisher
Australasian Medical Publishing CompanyLocation
Sydney, N.S.W.Link to full text
ISSN
0025-729XLanguage
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2003, Medical Journal of AustraliaUsage metrics
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No categories selectedKeywords
AdultAgedAged, 80 and overBenchmarkingCohort StudiesElectrocardiographyEmergency Medical ServicesEmergency TreatmentFemaleFibrinolytic AgentsGuideline AdherenceHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionMyocardial ReperfusionPractice Guidelines as TopicThrombolytic TherapyTime FactorsTreatment OutcomeVictoriaScience & TechnologyLife Sciences & BiomedicineMedicine, General & InternalGeneral & Internal MedicineCORONARY ANGIOPLASTYINTRAVENOUS STREPTOKINASETHERAPYDELAYISCHEMIADOOR
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