Mortality risk and complications relating to interhospital transfers of patients with acute coronary syndrome receiving primary coronary angioplasty performed by the Medical Emergency Service of Madrid 112: a group comparison study

Abstract

The performance of a primary percutaneous coronary intervention is the practice recommendation with the highest level of evidence for the treatment of acute coronary syndrome (ACS). If this intervention cannot be performed at the hospital where the patient is admitted, the patient must be transferred to a hospital with a haemodynamic laboratory. This can lead to a decreased availability of a mobile intensive care unit (MICU), contributing towards a lower survival rate of critical patients due to a delay in treatment administration. The aim of this study was to describe the risk of mortality, the complications, and the impact of interhospital transfer (IHT) in patients diagnosed with an ACS. Methods: A prospective observational study was performed comparing two patient groups: patients diagnosed with ST-segment elevation (STEMI) and patients diagnosed with non-ST-segment elevation. The variables collected included sex, age, cardiovascular risk factors, and any complications arising during IHT. Prior to being transported, the Risk Score for Transport Patients (RSTP) was used, together with the Rapid Emergency Medicine Score (REMS). The latter scale was repeated upon arrival at the accepting medical facility. Results: The study included 104 patients, of whom 67 were men (64.42%). Of these, 52.88% were diagnosed with STEMI. Patients with ACS presented an intermediate risk of mortality and the need for transfer to a MICU was indicated. The incidence of complications registered during transfers was 16.35%. Conclusions: The use of scales such as the REMS and the RSTP are helpful for obtaining a more objective risk profile, suited to the real needs of patients diagnosed with an ACS.