Abstract 14856: Availability of Cath Lab Facilities and Contemporary Inter-Hospital Transfer Patterns for the Management of Acute Coronary Syndromes Patients: Findings From the EPICOR Asia Study
Purpose: Little is known about acute coronary syndromes (ACS) management in relation to inter-hospital transfer and the potential role of on- or off-site cath lab facilities in Asia. This study describes real-world inter-hospital transfer patterns for ACS patients in Asia in terms of available cath lab.
Methods: EPICOR Asia (NCT01361386) is a prospective, multicountry, observational, cohort study of 12,993 consecutive ACS patients with non-fatal hospital discharge (51.4% STEMI, 19.9% NSTEMI, 28.8% UA). Patients were enrolled in Asia (219 hospitals/8 countries) from 06/2011 to 04/2012 and categorized as non-transferred (NT), transferred in (TI) from another hospital & discharged, or transferred out (TO) to a second hospital but discharged from their initial hospital after transfer back.
Results: 82.9% of ACS patients were NT, 16.9% TI & 0.2% TO. Coronary angiography was performed more often in patients hospitalized to centers with a 24/7 (82.7%) or non-24/7 (79.0%) cath lab vs no cath lab (8.8%). Discharge hospital characteristics are shown in the Table & reasons for transfer in the Figure. Overall, 84.4% of TI patients were transferred from a hospital with no cath lab. All TO patients were transferred out to a hospital with a cath lab. In STEMI, median time from symptom-onset to cath was shorter in NT (13.2 h) than TI (34.0 h) & TO (30.4 h), p<0.0001.
Conclusions: In Asia, coronary angiography is used much less often in ACS patients first hospitalized in centers with no cath facilities. Lack of either on-site cath lab or more advanced care are frequent reasons for interhospital transfer in ACS. Follow-up of these patients will help evaluate if these practice patterns affect outcomes.
- © 2013 by American Heart Association, Inc.