269 Delays in Transfer for Primary PCI

Abstract

Primary PCI is the preferred treatment modality for STEMI patients. Patients presenting to non-PCI capable facilities are increasingly being transferred for primary PCI. Transfer delays may be associated with poorer outcomes. We assessed the reasons for these delays within a referral network in Calgary, Alberta. We analyzed data from our STEMI registry regarding all walk-in acute STEMI patients presenting to non-PCI capable Calgary area hospitals between January 2008 and February 2012. The median DTRT (115 min, SD 70) was significantly longer for transfer patients (n=254) than for all patients presenting directly to the PCI centre (61 min, SD 45; n=1,071; p<0.001), as well as for direct walk-in patients (99 min, SD 72; n=117; p=0.046). 169 transfer patients had DTRT greater than 90 minutes. Areas where delays were identified are outlined in Table 1 (some patients had delays in more than one area).Tabled 1 Longer DTRT in transfer pPCI patients is largely related to the obligatory need for inter-hospital transfer. However, rapid ED assessment and activation of transport services may help to reduce reperfusion time.