Age, sex, racial disparities in heart attack hospital transfer patterns

Older, female and minority patients rushed to community hospitals with acute heart attacks are less likely to be transferred to a larger hospital that offers procedures to immediately open clogged arteries, Duke University Medical Center cardiologists have found.

The finding of such disparities is important, the researchers assert, since research has shown that even with the added transfer time, patients with an acute heart attack still fare better with artery-opening procedures -- such as angioplasty or bypass surgery than those treated only with powerful clot-busting drugs.

The researchers said their findings should help give physicians in smaller community hospitals more confidence about transferring such patients to larger hospitals. The researchers also said the reasons for such disparities remain to be explored, and that they are likely multifactorial.

In their analysis of almost 400,000 U.S. heart attack patients over the age of 64, the team also found that while heart attack patients who were not transferred tended to be sicker than those who were transferred, paradoxically, the sicker patients were those who would most likely benefit the most from artery-opening procedures, the researchers said.

"While the medical community is very proficient at treating complex illnesses like heart disease, there still remain disparities in the delivery of that care that needs to be addressed," said Duke cardiology fellow Jeffrey Berger, M.D., who presented the results of his analysis March 12, 2006, during the 55th annual scientific sessions of the American College of Cardiology in Atlanta.

"Our analysis found that in the U.S., patients over the age of 64 admitted with an acute heart attack to non-revascularization hospitals and then transferred were younger, more frequently male, white and at lower risk and had improved survival than those who remained at the community hospital," he continued.

Specifically, the team found

Contact: Richard Merritt
Duke University Medical Center

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