Observational studyEuropean heart journal. Acute cardiovascular care2013
Interhospital transfer due to failed prehospital diagnosis for primary percutaneous coronary intervention: an observational study on incidence, predictors, and clinical impact.
Observational study in European heart journal. Acute cardiovascular care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Sex differences in survival following acute coronary syndrome with and without standard modifiable risk factors.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Pooled it
- Sex differences in treatments and outcomes of patients with cardiogenic shock: a systematic review and epidemiological meta-analysis.Critical care (London, England) · 2024Pooled it
- Prehospital Prediction of Large Vessel Occlusion in Suspected Stroke Patients.Current atherosclerosis reports · 2018Pooled it
- Ischemic heart disease mortality trends and disparities in US adults from 1999 to 2023: a CDC WONDER analysis.Frontiers in cardiovascular medicine · 2026Article
- Demographics and regional trends of ischemic heart disease-related mortality in older adults in the United States, 1999-2020.PloS one · 2025Article
- Comparison of the diagnostic concordance of tele-EMS and EMS physicians in the emergency medical service-a subanalysis of the TEMS-trial.Frontiers in digital health · 2025Article
- OECD indicator 'AMI 30-day mortality' is neither comparable between countries nor suitable as indicator for quality of acute care.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Article
- Prehospital triage tools across the world: a scoping review of the published literature.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Pre- and Interhospital Workflow Times for Patients With Large Vessel Occlusion Stroke Transferred for Endovasvular Thrombectomy.Frontiers in neurology · 2021Article
- Gender-Related Differences in Chest Pain Syndromes in the Frontiers in CV Medicine Special Issue: Sex & Gender in CV Medicine.Frontiers in cardiovascular medicine · 2021Review
- Sex and gender: modifiers of health, disease, and medicine.Lancet (London, England) · 2020Review
- Gender differences in the revascularization rates and in-hospital outcomes in hospitalizations with ST segment elevation myocardial infarction.Irish journal of medical science · 2020Article
- Gender in cardiovascular medicine: chest pain and coronary artery disease.European heart journal · 2019Review
- Long-term outcome of elderly out-of-hospital cardiac arrest survivors as compared with their younger counterparts and the general population.Therapeutic advances in cardiovascular disease · 2018Article
- Diagnostic Discordance, Health Information Exchange, and Inter-Hospital Transfer Outcomes: a Population Study.Journal of general internal medicine · 2018Article
- Information handoff and outcomes of critically ill patients transferred between hospitals.Journal of critical care · 2016Observational
- Close, but not close enough.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2014Article
- Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor patients with ST-elevation myocardial infarction (STEMI), guidelines recommend prehospital triage and direct referral to a percutaneous coronary intervention (PCI)-capable centre in order to minimize ischemic time. However, few have studied failed prehospital diagnosis. We assessed the incidence, predictors, and clinical impact of interhospital transfer for primary PCI after initial referral to a non-PCI-capable centre due to a failed prehospital STEMI diagnosis.
methodsWe studied 846 consecutive STEMI patients undergoing primary PCI between January 2008 and January 2010.
resultsWe found that 609 patients (72%) were directly admitted through prehospital triage and 127 patients (15%) required interhospital transfer after failed prehospital diagnosis. Median first medical contact to treatment time was 88 min in the prehospital diagnosis group and 155 min in the interhospital transfer group (p<0.001). In the interhospital transfer group, the first available electrocardiogram was diagnostic for STEMI in 77% of cases. Predictors of interhospital transfer were female gender, diabetes, prior myocardial infarction, and greater event location to PCI-capable centre distance. Interhospital transfer independently accounted for a 47% increase in ischemic time (95% CI 33 to 63%; p<0.001). One-year mortality was higher in the interhospital transfer group (10 vs. 5.3%; p=0.030).
conclusionsDespite an often-diagnostic electrocardiogram, interhospital transfer after failed prehospital diagnosis occurred in 15% of STEMI patients undergoing primary PCI. Interhospital transfer was a major predictor of ischemic time and 1-year mortality was significantly higher. Continuing efforts to optimize prehospital triage are warranted, especially among patients at higher risk of failed prehospital diagnosis.
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