Harvard Heart Letter


Hospital-to-hospital transfer times need work. In the November 2011 Heart Letter, we reported the good news that hospitals nationwide have substantially reduced the time it takes a heart attack sufferer to start getting artery-opening angioplasty after arriving at the emergency room.

But not all hospitals are equipped to do emergency angioplasty. In those situations, people having a heart attack are usually transferred via ambulance to a hospital that can. The news about how long a person waits between arriving at the first hospital and leaving in an ambulance for hospital No. 2 (so-called door-in-to-door-out time) isn't so heartening.

Experts have set the ideal time for awaiting transfer at 30 minutes or less. Longer waits increase the risk of dying in a hospital by 56%. In a study, researchers found that among nearly 14,000 heart attack victims arriving at U.S. hospitals without emergency angioplasty capability in 2009, only 9.7% were transferred to a facility with such capability within 30 minutes. The average transfer time was 64 minutes (Archives of Internal Medicine, Nov. 28, 2011).

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