Published 15 June 2009, doi:10.1136/bmj.b2424
Cite this as: BMJ 2009;338:b2424

Letters

Door-to-balloon times

Ups and downs of balloon times

The first 150 words of the full text of this article appear below.

In the United States, treatment of ST elevation myocardial infarction by primary percutaneous coronary intervention is most effective if given within 90 minutes after admission to hospital.1 In the United Kingdom, the 90 minute door-to-balloon time is likely to be adopted as a hospital indicator of performance of percutaneous coronary intervention.

Management of acute coronary syndromes in all 228 acute hospitals in the UK is monitored nationally.2 3 We compared the recording of door-to-balloon time with in-hospital mortality during 2004-7 in the five largest centres performing percutaneous coronary intervention.

Patients who died in hospital were over 50% more likely to have incomplete data on door-to-balloon time than those who were discharged (relative risk 1.6, 99% confidence interval 1.2 to 1.9). Conversely, patients were more than twice as likely to have died in hospital if their door-to-balloon time was missing (2.1, 1.4 to 3.2).

This systematic bias introduced by incomplete data recording . . . [Full text of this article]

Brian A Cattle, research fellow1, Darren C Greenwood, senior lecturer in biostatistics1, Christopher P Gale, academic clinical lecturer in cardiology1, Robert M West, reader in health statistics1

1 Division of Biostatistics, University of Leeds, Leeds LS2 9JT

b.a.cattle@leeds.ac.uk


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Relevant Article

Association of door-to-balloon time and mortality in patients admitted to hospital with ST elevation myocardial infarction: national cohort study
Saif S Rathore, Jeptha P Curtis, Jersey Chen, Yongfei Wang, Brahmajee K Nallamothu, Andrew J Epstein, Harlan M Krumholz, and for the National Cardiovascular Data Registry
BMJ 2009 338: b1807. [Abstract] [Full Text] [PDF]

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