Utility of a new regional cardiac catheterisation laboratory

Abstract

Background: The Sunshine Coast Hospital and Health Service (SCHHS) services approximately 400,000 people over a large geographic area. In April 2012, the Cardiac Catheterisation Laboratory (CCL) opened and a Primary PCI (PPCI) service commenced in December 2012. The local Queensland Ambulance Service and peripheral hospitals are being educated to shift to PPCI as first-line treatment for STEMI. Aim: To analyse the distribution of PPCI cases and time between onset of symptoms, first medical contact and PCI. Methods and Results: Data on all PPCI patients since commencement to January 2015 were collected prospectively (n=405, 76% male, mean age 64.1±13.6 years). Excluding visitors to the area, of those with known postcode, the majority (88%) were transferred fromwithin 50km of the hospital (with 12% from >50km). Median [Inter-quartile Range] door-toballoon time was 48 [51] min. The median time to dispatch an ambulance was 1 [2] min and 34 [42] min until the patient arrived at NGH. Median first medical contact to balloon time was 119 [79] min over the entire cohort. Most patients received loading with a second anti-platelet (ticagrelor 60% or clopidogrel 35%) prior to arrival. Thirty-day mortality was 5% (22/405) including out-of-hospital cardiac arrest patients. Conclusion: The SCHHS Cardiac Catheter Laboratory is a heavily utilised, effective and efficient service. Despite its regional location, response times are comparable to established metropolitan services and within guideline recommendations. We continue to provide ongoing education to peripheral hospitals and the Queensland Ambulance Service aiming to optimise STEMI pre-transfer care.<br />