Rush Victims of Deadliest Heart Attacks to Specialty Centers
Posted Jul 27 2010 2:00pm
Researchers estimate this will save twice as many lives and be far less expensive as expanding specialized treatment
By Alan Mozes
Tuesday, July 27, 2010
TUESDAY, July 27 (HealthDay News) -- New research may shed some light on the ongoing public health debate regarding how to minimize the death rate from the most serious kinds of heart attacks, while also limiting health care costs.
One option under consideration is increasing the number of hospitals that are equipped to perform life-saving coronary angioplasty procedures, known as percutaneous coronary interventions (or PCI) -- a technique that offers these heart attack patients a better chance of survival and fewer complications than the standard treatment of clot-busting drugs.
But the new research suggests that rather than preparing more hospitals to offer the intervention, heart attack patients would have a better chance of survival if they were rushed by emergency medical services (EMS) to the closest available facility already equipped to offer PCI treatment.
The findings -- which suggest the latter is also the best way to keep health costs down -- were published online July 27 in Circulation: Cardiovascular Quality and Outcomes.
Earlier research has found that PCI is the best way to handle the deadliest kind of heart attack -- known as ST-segment elevation myocardial infarction, or STEMI -- which is caused by near-complete blockage of a coronary artery.
For that reason, the researchers used computer-simulation to evaluate strategies to make PCI interventions available to more patients -- since only one in four U.S. hospitals is currently equipped with the special labs needed to perform the procedure.
The computer simulation looked at 2,000 hypothetical cases of STEMI patients brought to care by various routes in Dallas.
The investigators found that standard ambulance delivery of patients to the nearest existing PCI care center was twice as effective and 20 times less expensive than expanding PCI availability to facilities not currently able to offer the intervention.
"Expanding patient access to PCI is critical to improving outcomes after heart attack, and there are a range of approaches to accomplish this," study lead author Thomas W. Concannon, assistant professor at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston, noted in a news release from the American Heart Association.
"Our study is the first to compare an EMS strategy of ambulance diversion to a number of hospital-based PCI expansion strategies," he added.
SOURCE: American Heart Association, news release, July 27, 2010