Driving Time to the Nearest Percutaneous Coronary Intervention-Capable Hospital and the Risk of Case Fatality in Patients with Acute Myocardial Infarction in Beijing.
Jie ChangQiuju DengPiaopiao HuZhao YangMoning GuoFeng LuYuwei SuJiayi SunYue QiYing LongJing LiuPublished in: International journal of environmental research and public health (2023)
Timely arrival at a hospital capable of percutaneous coronary intervention (PCI) is critical in treating acute myocardial infarction (AMI). We examined the association between driving time to the nearest PCI-capable hospital and case fatality among AMI patients. A total of 142,474 AMI events during 2013-2019 from the Beijing Cardiovascular Disease Surveillance System were included in this cross-sectional study. The driving time from the residential address to the nearest PCI-capable hospital was calculated. Logistic regression was used to estimate the risk of AMI death associated with driving time. In 2019, 54.5% of patients lived within a 15-min drive to a PCI-capable hospital, with a higher proportion in urban than peri-urban areas (71.2% vs. 31.8%, p < 0.001). Compared with patients who had driving times ≤15 min, the adjusted odds ratios (95% CI, p value) for AMI fatality risk associated with driving times 16-30, 31-45, and >45 min were 1.068 (95% CI 1.033-1.104, p < 0.001), 1.189 (95% CI 1.127-1.255, p < 0.001), and 1.436 (95% CI 1.334-1.544, p < 0.001), respectively. Despite the high accessibility to PCI-capable hospitals for AMI patients in Beijing, inequality between urban and peri-urban areas exists. A longer driving time is associated with an elevated AMI fatality risk. These findings may help guide the allocation of health resources.
Keyphrases
- acute myocardial infarction
- percutaneous coronary intervention
- st segment elevation myocardial infarction
- coronary artery disease
- st elevation myocardial infarction
- end stage renal disease
- acute coronary syndrome
- healthcare
- left ventricular
- antiplatelet therapy
- cardiovascular disease
- coronary artery bypass grafting
- newly diagnosed
- chronic kidney disease
- ejection fraction
- air pollution
- peritoneal dialysis
- prognostic factors
- public health
- emergency department
- mental health
- heart failure
- electronic health record
- cardiovascular risk factors