In a press release discussed on medicalnews.com, cardiologists from Duke University Medical Center, who studied hospital transfer patterns for patients rushed to community hospitals with acute heart attacks, disclosed that age, sex, and race play a significant role in determining who (and how quickly) a patient is transferred to a larger hospital for critical cardiac treatment.
The results of the study, which examined the records of almost 400,000 heart attack patients over the age of 64, were presented yesterday at the annual scientific sessions of the American College of Cardiology in Atlanta, Georgia.
The research team found that older, female, and minority patients who were brought to smaller community hospitals are less likely to be transferred to a larger hospital equipped to perform procedures to immediately open clogged arteries.
Surprisingly, even with the disparities in transfer time, patients suffering acute heart attacks still respond better to such procedures (including angioplasty and coronary bypass surgery) than those treated with clot-busting medications alone.
In addition, the team found that patients who were not transferred tended to be sicker than those that were. Ironically, these were the very patients who would benefit most from the procedure offered at the larger hospitals.
Some of the specific findings were that men were 16% more likely to be transferred than women; whites were 31% more likely than blacks and 47% more likely than Hispanics to be transferred; and as a patient’s age increased, the likelihood of being transferred decreased.
Of the 399,775 patients over 64 studied (2001-2003 data from the Centers for Medicare and Medicaid Services), who were admitted with acute heart attacks to facilities where angioplasties or bypass surgery could not be performed, only 35% were ever transferred to a hospital offering such revascularization procedures. The team found that in the case of transferred patients, 8.7% died, while 18.5% of the patients who were not transferred died. Â
The researchers believe that their findings should encourage doctors at smaller medical facilities to effect transfers of these particular patients to better equipped hospitals more quickly. This is especially so since clot-busting drugs, which are offered at all hospitals, do not always work and are contraindicated for many patients for various reasons.
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