OBJECTIVES: This study sought to evaluate the effect of systematic data analysis and standardized feedback on treatment times and outcome in a prospective multicenter trial. BACKGROUND: Formalized data feedback may reduce treatment times in ST-segment elevation myocardial infarction (STEMI). METHODS: Over a 15-month period, 1,183 patients presenting with STEMI were enrolled. Six primary percutaneous coronary intervention hospitals in Germany and 29 associated nonpercutaneous coronary intervention hospitals participated. Data from patient contact to balloon inflation were collected and analyzed. Pre-defined quality indicators, including the percentage of patients with pre-announced STEMI, direct handoff in the catheterization laboratory, contact-to-balloon time <90 min, door-to-balloon time <60 min, and door-to-balloon time <30 min were discussed with staff on a quarterly basis. RESULTS: Median door-to-balloon time decreased from 71 to 58 min and contact-to-balloon time from 129 to 103 min between the first and the fifth quarter (p < 0.05 for both). Contributing were shorter stays in the emergency department, more direct handoffs from ambulances to the catheterization laboratory (from 22% to 38%, p < 0.05), and a slight increase in the number of patients transported directly to the percutaneous coronary intervention facility (primary transport). One-year mortality was reduced in the total group of patients and in the subgroup of patients with primary transport (p < 0.05). The sharpest fall in mortality was observed in patients with primary transport and TIMI (Thrombolysis In Myocardial Infarction) risk score ≥ 3 (n = 521) with a decrease in 30-day mortality from 23.1% to 13.3% (p < 0.05) and in 1-year mortality from 25.6% to 16.7% (p < 0.05). CONCLUSIONS: Formalized data feedback is associated with a reduction in treatment times for STEMI and with an improved prognosis, which is most pronounced in high-risk patients. (Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction [FITT-STEMI]; NCT00794001).
OBJECTIVES: This study sought to evaluate the effect of systematic data analysis and standardized feedback on treatment times and outcome in a prospective multicenter trial. BACKGROUND: Formalized data feedback may reduce treatment times in ST-segment elevation myocardial infarction (STEMI). METHODS: Over a 15-month period, 1,183 patients presenting with STEMI were enrolled. Six primary percutaneous coronary intervention hospitals in Germany and 29 associated nonpercutaneous coronary intervention hospitals participated. Data from patient contact to balloon inflation were collected and analyzed. Pre-defined quality indicators, including the percentage of patients with pre-announced STEMI, direct handoff in the catheterization laboratory, contact-to-balloon time <90 min, door-to-balloon time <60 min, and door-to-balloon time <30 min were discussed with staff on a quarterly basis. RESULTS: Median door-to-balloon time decreased from 71 to 58 min and contact-to-balloon time from 129 to 103 min between the first and the fifth quarter (p < 0.05 for both). Contributing were shorter stays in the emergency department, more direct handoffs from ambulances to the catheterization laboratory (from 22% to 38%, p < 0.05), and a slight increase in the number of patients transported directly to the percutaneous coronary intervention facility (primary transport). One-year mortality was reduced in the total group of patients and in the subgroup of patients with primary transport (p < 0.05). The sharpest fall in mortality was observed in patients with primary transport and TIMI (Thrombolysis In Myocardial Infarction) risk score ≥ 3 (n = 521) with a decrease in 30-day mortality from 23.1% to 13.3% (p < 0.05) and in 1-year mortality from 25.6% to 16.7% (p < 0.05). CONCLUSIONS: Formalized data feedback is associated with a reduction in treatment times for STEMI and with an improved prognosis, which is most pronounced in high-risk patients. (Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction [FITT-STEMI]; NCT00794001).
Authors: Georg Fuernau; Karl Fengler; Steffen Desch; Ingo Eitel; Franz-Josef Neumann; Hans-Georg Olbrich; Antoinette de Waha; Suzanne de Waha; Gert Richardt; Marcus Hennersdorf; Klaus Empen; Rainer Hambrecht; Christian Jung; Michael Böhm; Janine Pöss; Ruth H Strasser; Steffen Schneider; Taoufik Ouarrak; Gerhard Schuler; Karl Werdan; Uwe Zeymer; Holger Thiele Journal: Clin Res Cardiol Date: 2016-07-04 Impact factor: 5.460
Authors: Ehete Bahiru; Anubha Agarwal; Mark A Berendsen; Abigail S Baldridge; Tecla Temu; Amy Rogers; Carey Farquhar; Frederick Bukachi; Mark D Huffman Journal: Circ Cardiovasc Qual Outcomes Date: 2019-09-06
Authors: Karl Heinrich Scholz; Thomas Meyer; Björn Lengenfelder; Christian Vahlhaus; Jörn Tongers; Steffen Schnupp; Rainer Burckhard; Nicolas von Beckerath; Hans-Martin Grusnick; Andreas Jeron; Klaus Dieter Winter; Sebastian K G Maier; Michael Danner; Jürgen Vom Dahl; Stefan Neef; Stefan Stefanow; Tim Friede Journal: Open Heart Date: 2021-05
Authors: Eva C L Rasenack; Martin Oehler; Albrecht Elsässer; Meinhard Schilling; Lars S Maier Journal: Clin Res Cardiol Date: 2012-09-29 Impact factor: 5.460