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Medscape
15 hours ago
- Health
- Medscape
Missed Target Treatment Times May Increase MI Mortality
When it comes to delivering timely treatment for patients experiencing myocardial infarction (MI), many hospitals are continuing to fall short of national guidelines, new research showed. Benchmarks for percutaneous coronary intervention, the standard of care for acute ST-elevation MI (STEMI), aren't being met in some cases. Delays in care in the key metric of the time from first contact with medical care to angioplasty with stenting resulted in worse patient outcomes and were associated with increased in-hospital mortality risk in some cases, according to the findings, published on June 11 in JAMA Cardiology . 'There are two categories of patient delays: Those that are patient-centered and those that are system-centered,' said Neal S. Kleiman, MD, Houston Methodist DeBakey Heart and Vascular Center, Houston, the senior author of the new study. 'We don't have control over patient-related factors, but there is a lot we can do in terms of hospital systems.' For the retrospective cross-sectional study, Kleiman and his colleagues analyzed data on 73,826 patients with STEMI or STEMI equivalent from 503 sites across the United States. The goal was to determine site-level variability in patterns of treatment times and clinical outcomes from 2020 to 2022 based on an analysis of data from the American Heart Association's Get With the Guidelines — Coronary Artery Disease registry — a quality improvement program for patients with coronary artery disease, acute MI and chest pain. The authors said the study is the first large-scale analysis of treatment goals and outcomes in STEMI based on hospital performance. The researchers found an association between failure to reach the target time from first medical contact with care to angioplasty with stenting — 90 minutes or less — and increased risk for in-hospital mortality for primary presentations and transfers (adjusted odds ratio, 2.21; 95% CI, 2.02-2.42, and 2.44; 95% CI, 1.90-3.12, respectively). Low-performing hospitals were associated with increased risk for mortality and longer stays in the hospital than were high-performing hospitals. However, hospital location and case volume were not associated with worse outcomes. The guidelines recommend a target time from first contact with care to angioplasty with stenting of 90 minutes or less for patients presenting directly to hospitals offering angioplasty with stenting and 120 minutes or less for patients requiring transfer to a facility offering the procedure. The study findings revealed significant variability between hospital sites in meeting the key metric of the recommendations — adherence in at least 75% of patients with STEMI. At hospitals with the capability to perform angioplasty with stenting, the target was met in 72.2% of patients at high-performing sites, 60.8% at intermediate-performing sites, and 46.0% at low-performing sites. When patients required transfers to other facilities with the capability to perform angioplasty, a target first medical contact-to-device treatment time of 120 minutes or less was achieved in 72.3% of patients at high-performing sites, 48.8% at intermediate performing sites, and 21.9% at low-performing sites, according to the researchers. In these hospitals, treatment delays were caused primarily by longer stays in the emergency department and time from arrival in the catheterization laboratory to stenting. Limitations of the study included the fact registry responses were provided on a voluntary basis and may not reflect the totality of STEMI care in all geographical areas, according to the researchers. The analysis also lacked data on follow-up after discharge, making it difficult to extrapolate the findings over the long term, they said. Yasser M. Sammour, MD, MSc, cardiology fellow at Houston Methodist DeBakey Heart and Vascular Center, who led the work, said several decades of research have highlighted the importance of treating patients with STEMI efficiently. A previous registry study found fewer treatment delays were linked to reduced mortality. 'The current study tried to take that research one step further, assessing how factors such as hospital performance and location affect patient outcomes,' Sammour said. The result, he said: 'We're still underperforming. We need to have coordinated strategies with local intervention at the hospital level to examine where significant delays in percutaneous coronary intervention time are occurring.' The absence of uniformity in established performance measures such as time to initiate treatment in STEMI has led to calls for greater adherence to current recommendations. In an editorial accompanying the journal article, Roxana Mehran, MD, Mount Sinai Fuster Heart Hospital in New York City, wrote: 'After two decades of data collection, national initiatives, and public accountability, the next step must involve tailored solutions addressing barriers within each institution. Bridging the gap now requires renewed efforts and commitments to prioritize timely, coordinated STEMI care. Until then, the clock will continue to tick — against our patients.'
Yahoo
31-05-2025
- Business
- Yahoo
Houston Methodist inaugurates 570,000ft² hospital facility in Cypress, Texas
US-based healthcare system Houston Methodist has opened the Houston Methodist Cypress Hospital, a medical facility designed to serve patients in Cypress, Texas. The 570,000ft² hospital provides a renovated central utility plant and a range of medical services for the local community. It has been built with a focus on advanced technology, featuring full 5G connectivity and patient rooms equipped with voice-controlled settings. The $685m project includes a seven-storey hospital and two six-storey medical office buildings, each of which covers 160,000ft². It has 100 licensed beds, nine operating rooms and nine imaging modalities. The facility includes a critical care unit, an emergency department, and a birthing centre to cater to diverse medical requirements. It also makes use of a da Vinci 5 surgical robot, which aims to enhance its capability for minimally invasive surgeries. Houston Methodist Design and Construction Department developed Houston Methodist Cypress Hospital in partnership with engineering consultant Jacobs, which provided project and construction management services. Jacobs' vice-president and healthcare construction global principal David Syphard said: 'At Jacobs, we understand the importance of delivering high-quality healthcare facilities that meet the evolving needs of communities. 'Our collaborative approach and dedication to excellence have resulted in a hospital that not only provides top-tier medical services but also fosters a positive impact on the Cypress community.' Based in Texas, Houston Methodist offers personalised care for local residents via primary, speciality, emergency and hospital care facilities. As of last year, the healthcare system has eight hospitals and one academic institute, as well as several emergency care, comprehensive care and imaging centres. These facilities employ more than 30,000 colleagues and around 5,000 affiliated physicians in total. In August 2022, Houston Methodist partnered with technology innovation space Ion to establish a healthcare technology innovation centre. "Houston Methodist inaugurates 570,000ft² hospital facility in Cypress, Texas" was originally created and published by Hospital Management, a GlobalData owned brand. The information on this site has been included in good faith for general informational purposes only. It is not intended to amount to advice on which you should rely, and we give no representation, warranty or guarantee, whether express or implied as to its accuracy or completeness. You must obtain professional or specialist advice before taking, or refraining from, any action on the basis of the content on our site. Sign in to access your portfolio
Buzz Feed
02-04-2025
- Health
- Buzz Feed
"That May Be A Cause For Concern": These Stomach Pain Symptoms Are A Sign You Need To Seek Medical Attention ASAP
Everyone experiences a stomachache every so often, whether that's because you ate something that didn't agree with you or maybe you're constipated. These aches and pains tend to go away on their own either after a bowel movement or just a little bit of time. However, there are some cases when stomach pain may warrant a trip to the emergency room ― especially if the pain is severe enough to make you concerned. Based on data from the Centers for Disease Control and Prevention's National Hospital Ambulatory Medical Care Survey, abdominal pain is the leading chief complaint among emergency department visits, accounting for 8.8% of all visits. We spoke with gastroenterologists about different types of stomach pain and when you'll want to visit the emergency room for more immediate medical attention: 1. Sharp, stabbing pain that's in one specific spot or moves around the belly button. If you are experiencing a sharp, stabbing pain in your stomach, then you'll want to take a trip to the emergency room as soon as possible. 'A sharp, stabbing, more focal pain that reaches six or higher on the pain scale may be associated with a peptic ulcer. Or, if located in the right lower abdomen or shifts from the area around the belly button to the right lower abdomen, may indicate acute appendicitis,' said Dr. Jean-Pierre Raufman, a gastroenterologist and chief of gastroenterology and hepatology at University of Maryland Medical Center. ″ This type of pain should be evaluated by a health care provider sooner rather than later since it is likely to require specific treatment or even surgery.' 2. Consistent, throbbing pain that isn't getting better. According to Dr. Feenalie Patel, a gastroenterologist at Houston Methodist, throbbing pain may be a sign of muscle injury or more severe organ injury, including appendicitis, pancreatitis, hernia, etc. 'The location of your pain may suggest which organs are involved, but pain can often radiate and move, so it is important to seek care so your doctor can help identify the cause of your pain,' she said. 3. Pain in the right upper and lower quadrants of your stomach. If your stomach pain is in the upper and lower right quadrants of your stomach, then that may be a cause for concern and could warrant a visit to the ER. 'Pain in the right upper abdomen may reflect gallbladder disease, perhaps from gallstones,' Raufman said. 4. Severe pain in the lower abdomen. If you notice pain in the lower quadrants of your stomach that persists and is sharp and unbearable, then that could mean a trip to the ER may be warranted. Not all lower stomach pain is serious, but Dr. Douglas Sprung, a gastroenterologist at The Gastroenterology Group in Florida, said that you'll want to be cautious of appendicitis, which is mostly in the right lower quadrant, and diverticulitis, which is mostly in the left lower quadrant. 5. Swelling in the abdomen or other accompanying symptoms. In addition to stomach pain, if you have other worsening symptoms like swelling, that means you should go to the emergency room straight away. 'Abdominal pain associated with swelling of the abdomen, abdominal tenderness ― that is, touching or pushing on the abdomen worsens the pain, or chest pain, persistent vomiting or yellowing of the skin (jaundice) is concerning,' Raufman said. 6. Pain with fever or bleeding. 'If abdominal pain is associated with rectal bleeding or vomiting blood, or severe abdominal pain with concomitant fever, sweats, and chills, these are times to consider going to the ER/hospital for medical evaluation, blood testing, and ultrasound testing,' Sprung said. Are there cases where you should try to treat your pain at home first? If your stomach pain doesn't exactly match the descriptions above ― or you don't think it's severe enough to warrant a trip to the emergency room right away ― then there are some things you can try at home first to see if it helps. For starters, Raufman suggested going easy on your diet to see if it helps your symptoms. Eat foods like 'crackers, bananas, or other easily digestible foods and [drink] plenty of water,' he said. Next, you can try over-the-counter medications. 'A trial of Tums, Pepcid, or Mylanta for heartburn or upper abdominal burning can be done before going to the ER,' Sprung said. 'If symptoms are a lot better, then continue that until you can get to your doctor.' Lastly, if you think your stomach pain is related to constipation or gas, Patel recommended light exercise to help move your colon, over-the-counter gas (e.g. simethicone) or constipation (e.g. Miralax, stool softener) medications, and fiber-rich foods to help. At the end of the day, you know your body better than anyone else. If you notice something doesn't feel right or the pain doesn't subside, you'll want to take a visit to the emergency room just in case. It's always better to be cautious. HuffPost.
