|
E-mail this page to a friend!
Senior Citizen Health & Medicine
Heart Attack Patients Have Better Chance with Faster
Door-to-Balloon Times
Researchers find best ERs have specific plans
to achieve goal
 November
14, 2006 – The time it takes to get a heart attack patient from the door
of the emergency room until the blood flow is restored to the heart by
opening the blockage with angioplasty is critical, and researchers say
they now know specific strategies to hasten this life-saving span of
time from "door to balloon." The report yesterday in the New England
Journal of Medicine coincides with a new campaign to improve
door-to-balloon times that is named, "DSB."
| |
Related Stories |
|
| |
Death Risk Jumps for Heart Failure Patients with Low
Systolic Blood Pressure
Heart failure most common hospital discharge
diagnosis for seniors
 November 7, 2006 – Patients admitted to hospitals
with heart failure and low systolic blood pressure are more likely to
have problems, including a significantly higher risk of death, despite
medical treatment, says a study to be published tomorrow in the Journal
of the American Medical Association.
Read more...
Senior Citizens on Medicare Substantially Lower
Death Risk by Choosing 5-Star Hospitals
HealthGrades 2007 hospital-quality study looked a
40.6 million Medicare records
October 16, 2006 – Senior citizens can lower their
death risk during a hospitalization by 69 percent by getting their
treatment at a top-rated hospital ("5 star") rather than a 1-star rated
hospital. This conclusion was released today as part of the largest
annual study of hospital quality in America by HealthGrades. This
"quality chasm" between the best and poorest-performing hospitals has
grown by approximately 5 percent since last year's study, even as
overall mortality rates have improved by nearly 8 percent.
Read more...
Women Still Get Less Heart Attack Care than Men,
More Likely to Die in Year
Older women, too, had a much lower risk of dying
with proper treatment
 July 10, 2006 - A new study shows that a puzzling
gap between the sexes persists in hospital care for heart attack
patients, despite specific efforts by hospitals to improve the way they
treat all patients immediately after a heart attack. The difference may
help explain why women in the study were much more likely than men to
die within a year of being hospitalized for a heart attack. Even older
women in the study had a much lower risk of dying if they received
proper treatment. Read
more...
Read more
on
Health & Medicine |
|
The researchers at Yale School of Medicine found
hospitals that provide the most rapid emergency angioplasty are
successful because of specific strategies to expedite the care of
patients with heart attacks.
The timeliness of heart attack care in hospitals
varies widely across the country, according to the authors. In this
study, 365 hospitals nationwide were surveyed about how they treat heart
attack patients.
The researchers identified strategies that were
correlated with "door-to-balloon" time--the time from when a patient
enters hospital doors to the time blood flow is restored to the heart by
opening a blockage with angioplasty. The faster patients are treated,
the better their likelihood of survival.
The study found that among the hospitals sampled,
the range of door-to-balloon times was between 55 and 120 minutes. The
national guideline for door-to-balloon time is 90 minutes or less. Many
hospitals do not achieve these national guidelines for even most of
their patients. However, some hospitals do better than others and six
strategies were associated with significantly faster door-to-balloon
times.
These strategies included
● having emergency medicine physicians activate the catheterization
laboratory,
● having a single call to a central page operator activate the
laboratory,
● having the emergency department activate the catheterization
laboratory while the patient is en route to the hospital,
● expecting staff to arrive in the catheterization laboratory within
20 minutes after being paged,
● having an attending cardiologist always on site and having staff in
the emergency department and
● having the catheterization laboratory use real-time data feedback
for staff about their performance.
"Despite the effectiveness of these strategies, a
minority of the hospitals surveyed were using them, even though many of
the strategies were feasible and could be immediately implemented," said
lead author Elizabeth Bradley, professor of public health in the
Department of Epidemiology and Public Health at Yale.
"We know that reducing door-to-balloon time is
important, but now we also have more evidence about how to achieve
faster door-to-balloon times," Bradley said.
"Having a good interventional cardiologist is not
enough. How the hospital processes are organized and managed, and how
teams work together within the hospital really matters to patient
outcomes, especially in heart attack care, which requires coordination
among many different staff members."
The study coincides with the launch of the new
"D2B" campaign by the American College of Cardiology, the American Heart
Association and other partners, to improve door-to-balloon times by
providing hospitals with practical tools to achieve this goal.
The campaign, which will help educate hospitals on
how to implement these six strategies, derives in large part from a
four-year National Institutes of Health grant that helped to produce
this study.
"With this and previous studies, we have generated
the knowledge that can help all hospitals provide timely care to their
patients," said study co-author Harlan Krumolz, M.D., the Harold H.
Hines, Jr. Professor of Medicine at Yale School of Medicine at Yale.
"With the D2B campaign to translate the science into action, we want to
see what is currently considered outstanding care become standard and
routine care. These strategies provide the roadmap for that to happen."
Krumholz said most of the D2B recommendations are
reasonably straightforward but in some cases require a change in
culture, including increased collaboration between emergency department
physicians and interventional cardiologists.
"The project is designed for all hospitals--to help
the best get even better and those who are lagging in door-to-balloon
times to catch up," said Krumholz. "We are seeking to sign up every
hospital in the country that offers emergency angioplasty for patients
with heart attacks.
In addition to Bradley and Krumholz, the
multidisciplinary team of authors on the NEJM article included Jeph
Herrin, Yongfei Wang, Barbara Barton, Tashonna Webster, Jennifer Mattera,
Sarah Roumanis, Jeptha Curtis, M.D., Brahmajee Nallamothu, M.D., David
Magid, M.D., Robert McNamara, M.D., Janet Parkosewich and Jerod Loeb.
The study was funded by the National Heart, Lung
and Blood Institute and the Patrick and Catherine Weldon Donaghue
Medical Research Foundation.
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
