Vol. 7, Issue 1, Part C (2025)

Background: Timely transfer for PCI is crucial in managing STEMI, reducing myocardial damage, optimizing reperfusion therapy, and minimizing post-procedural complications. This study aimed to assess in-hospital outcomes of patients with STEMI transferred for PCI versus those directly admitted to PCI centers.
Methods: The National Inpatient Sample (NIS) was analyzed for STEMI patients undergoing PCI between 2016-2021. Patients were categorized as primarily admitted or transferred based on transfer indicators. Logistic and linear regression models evaluated in-hospital mortality, length of stay, hospital charges, and post-procedure complications.
Results: A weighted national estimate of 748,430 STEMI patients underwent PCI, with 625,520 directly admitted and 122,910 transferred. The mean patient age was 62 years, and 72% were male. Mortality rates did not significantly differ between groups. However, transferred patients had longer hospital stays (mean difference: 0.76 days, 95% CI: 0.68-0.85, P<0.000) and higher healthcare costs (mean increase: $5,563, 95% CI: $2,449-$8,678, P<0.000). They also had higher odds of complications, including cardiogenic shock (aOR: 1.50, 95% CI: 1.08-2.09, P<0.015), cerebrovascular accidents (aOR: 3.58, 95% CI: 1.10-11.63, P<0.034), and kidney failure (OR: 2.06, 95% CI: 1.05-4.04, P<0.036).
Conclusion: While mortality was similar, transferred STEMI patients had longer hospital stays, greater costs, and higher odds of post-procedure complications, highlighting the need for optimized transfer protocols to improve outcomes.