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      Process factors affecting door to percutaneous coronary intervention for acute myocardial infarction patients.

      American journal of medical quality : the official journal of the American College of Medical Quality
      Acute Disease, Adult, Aged, Aged, 80 and over, Angioplasty, Balloon, Coronary, statistics & numerical data, Cross-Sectional Studies, Emergency Medical Services, organization & administration, Female, Hospitals, Community, Humans, Male, Middle Aged, Myocardial Infarction, surgery, Process Assessment (Health Care), Quality of Health Care, Retrospective Studies, Time Factors, Urban Population

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          Abstract

          The purpose of this cross-sectional study was to identify key predictor variables with the most impact on door-to-balloon time for acute myocardial infarction patients. The authors examined arrival, process, and patient-related variables from retrospective data from calendar years 2006 and 2007 within a single community hospital (N = 273). The door-to-balloon time ranged from 28 to 167 minutes, with an average of 76.77 (standard deviation ±24.5) minutes. Key predictor variables identified through multivariate linear regression included portable chest X-ray, presentation from walk-in versus ambulance, responding cardiology group, emergency department (ED) time of arrival (day 8 AM to 5 PM or night 5 PM to 8 AM), ED day of arrival (weekday or weekend), if a code R was called prior to arrival, and if the patient was identified as having chest pain on admission to the ED. For patients with acute myocardial infarction at a single study site, the authors identified a number of key factors that delay prompt reperfusion.

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