Our View: Our hospitals can do better for heart attack patients
In the grips of a life-threatening heart attack, immediate medical attention is critical, right? Perhaps more so than you may have imagined. Two-thirds of hospitals fail to provide emergency care quickly enough to heart attack patients, according...
In the grips of a life-threatening heart attack, immediate medical attention is critical, right? Perhaps more so than you may have imagined.
Two-thirds of hospitals fail to provide emergency care quickly enough to heart attack patients, according to a study posted online by the New England Journal of Medicine. If every hospital met American Heart Association and American College of Cardiology guidelines for care, an additional 1,000 patients a year could be saved, the findings suggested. About 10,000 patients die annually in hospitals after suffering heart attacks.
That's far too many. Hospitals can and must do better.
On Sunday, the National Heart, Lung and Blood Institute agreed, launching a national campaign to help hospitals improve. To their credit, many hospitals, insurers and government agencies already are on board with the long-overdue effort.
Specifically, a patient's risk of dying can be cut by 40 percent if clogged arteries are reopened with a tiny balloon within 90 minutes of arrival at a hospital. However, only about one-third of hospitals meet that time frame, the study found. And fewer than half of the 365 hospitals surveyed perform balloon angioplasties within 91 to 120 minutes.
In Duluth, St. Mary's Duluth Clinic Heart Center's so-called "door-to-balloon" time averages 70 minutes, according to Dr. Albert Deibele, chief of cardiology. "We're constantly working to improve our times and improve quality," he said.
At St. Luke's Hospital, the door-to-balloon goal has long been 90 minutes, though Dr. Mary Boylan, a cardiothoracic surgeon, didn't immediately know Monday how often the goal is met. The U.S. Department of Health and Human Services had an idea, stating on its "Hospital Compare" Web site that St. Luke's performed angioplasties or other percutaneous coronary interventions within 120 minutes of arrival 85 percent of the time. St. Mary's Duluth Clinic performed the emergency procedures within 120 minutes 75 percent of the time.
That means both Duluth hospitals outperformed the national average (65 percent) and were in line with the statewide average (86 percent). Both rated similarly, too, with other procedures recommended in the treatment of heart attacks.
For example, St. Mary's provided aspirin to patients upon their arrival 100 percent of the time, making it a "top hospital" in the category. St. Luke's provided aspirin upon arrival 94 percent of the time. The state and national averages were 92 percent. Aspirin can help reduce the severity of a heart attack. Continued use of aspirin after discharge can help reduce the risk of another heart attack. St. Mary's provided aspirin at discharge 99 percent of the time and St. Luke's 97 percent. Both were better than the national (89 percent) and state (94 percent) averages. Top hospitals provided aspirin at discharge 100 percent of the time, however.
Likewise, top hospitals provided beta blockers -- a medicine that lowers blood pressure, treats chest pain and heart failure, and prevents additional heart attacks -- 100 percent of the time both at check-in and check-out from the hospital. St. Mary's provided beta blockers 96 percent of the time at arrival and 99 percent of the time at discharge, St. Luke's 86 percent at arrival and 99 percent at discharge. The state averages were 90 percent and 91 percent, respectively. The national averages were 86 percent and 88 percent, respectively.
That's not a lot of 100 percents, meaning "we're [still] losing too many lives," as Steve Nissen of the Cleveland Clinic and president of the American College of Cardiology put it.
And now that the numbers are out, there's no reason not to do better.
"I know we have been improving," Dr. Boylan told the News Tribune editorial page yesterday. "We look at our numbers all the time. We're always working to improve our numbers. And we have a hospital that's committed to doing it."
For more information about how hospitals stack up in the treatment of heart attacks, heart failure, pneumonia and other health problems, or to learn more about specific hospitals, visit this Web site sponsored by the U.S. Department of Health and Human Services: www.hospitalcompare.hhs.gov