ArticlePloS one2016
The Tradeoff between Travel Time from Home to Hospital and Door to Balloon Time in Determining Mortality among STEMI Patients Undergoing PCI.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Relationship of Distance to PCI Center With In-Hospital Mortality After STEMI: Insights From a Rural Regional STEMI Network.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Designing a clustering algorithm for optimizing health station locations.International journal of health geographics · 2025Article
- Can we optimize locations of hospitals by minimizing the number of patients at risk?BMC health services research · 2023Article
- Potential Access to Emergency General Surgical Care in Ontario.International journal of environmental research and public health · 2022Article
- Effect of Transport Time on the Use of Reperfusion Therapy for Patients with Acute Ischemic Stroke in Korea.Journal of Korean medical science · 2021Article
- High quality process of care increases one-year survival after acute myocardial infarction (AMI): A cohort study in Italy.PloS one · 2019Article
- Article
- The proportion of South Africans living within 60 and 120 minutes of a percutaneous coronary intervention facility.Cardiovascular journal of AfricaArticle
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn ST-segment elevation myocardial infarction (STEMI), even in presence of short door to balloon time (DTBT), timely reperfusion with percutaneous coronary intervention (PCI) is hampered by pre-hospital delays. Travel time (TT) constitutes a relevant part of these delays and may contribute to worse outcomes.
objectiveTo evaluate the relationship between TT from home to hospital and DTBT on 30-day mortality after PCI among patients with STEMI.
methodsWe enrolled a cohort of 3,608 STEMI patients with a DTBT within 120 minutes who underwent PCI between years 2009 and 2013 in Lazio Region (Italy). We calculated the minimum travel time from residential address to emergency department where the first medical contact occurred. We defined system delay as the sum of travel time and DTBT time. Logistic regression models, including clinical and demographic characteristics were used to estimate the effect of TT and DTBT on mortality.
resultsAmong patients with 0-90 minutes of system delay, TT above the median value is positively associated with mortality (OR = 2.46; P = 0.009). Survival benefit associated with DTBT below the median results only among patients with TT below the median (OR for DTBT below the median = 0.39; P = 0.013), (OR for interaction between TT and DTBT = 2.36; p = 0.076).
conclusionTT affects survival after PCI for STEMI, even in the presence of health care systems compliant with current guidelines. Results emphasize the importance of health system initiatives to reduce pre-hospital delay. Utilization of TT can contribute to a better estimate of patient mortality risk in the evaluation of quality of care.
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