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Distance From Advanced Cardiac Care Affects Odds of Survival

For patients with acute coronary syndromes plus cardiogenic shock, geography may affect outcome

MONDAY, Feb. 5, 2018 (HealthDay News) — In patients with acute coronary syndromes (ACS) complicated by cardiogenic shock (CS) in Nova Scotia, Canada, access to cardiac catheterization independently predicts survival, but those farthest from the center offering cardiac catheterization are the least likely to be transferred, according to a study published recently in the Canadian Journal of Cardiology.

John Colin Boyd, from Dalhousie University in Halifax, Canada, and colleagues used data from the clinical database of Cardiovascular Health Nova Scotia to determine in-hospital mortality among 418 consecutive patients diagnosed with ACS and CS in Nova Scotia from 2009 to 2013.

The researchers found that access to invasive care was available for 73.9 percent of these patients. Nearly two-thirds (64.2 percent) of those who presented elsewhere in the province were transferred to the Queen Elizabeth II Health Sciences Centre, the only center in the province offering invasive cardiac care. For the 309 patients with access to invasive care, the mortality rate was significantly lower than that of the 109 patients who did not have access (41.7 versus 83.5 percent). Access to cardiac catheterization remained an independent predictor of survival (odds ratio, 0.2) after adjustment for clinical differences.

“Patients who lived the furthest from Halifax were least likely to be transferred, suggesting that geography alone may still remain an important barrier to live saving care,” the authors write.

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