45 Outcome of stemi patients admitted through inter-hospital transfer vs direct admission to ppci centre

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Background Primary PCI is the treatment of choice in patients presenting with ST elevation myocardial infarction. . The delay in reperfusion leads to increased morbidity and mortality. The secular trends in the impact of inter-hospital transfers (IT) on mortality in the United Kingdom (UK) have not been recently investigated. Aim To investigate the impact of Inter-hospital transfers on in-hospital major adverse cardiovascular events and 5 years mortality among patients admitted to a tertiary care Centre in the UK Methods The patient level data on STEMI patients admitted between 2011 to 2021 were retrospectively collected in line with (NICOR) data fields. We compared baseline characteristics and mortality data of IT group to age and gender matched DA group.Primary end point was in hospital major cardiovascular complications and secondary end point was mortality at five years for patients admitted from 2011 to 2016. Of 4269 patients, 3044 (71%) were directly admitted and 1225 (29%) presented by inter hospital transfer. Inter hospital transfer group were more likely to present with cardiogenic shock and their median call to balloon time was 108 minutes longer than direct admission group. There was no significant difference in MACE during hospital admission between the two groups except for in-hospital mortality which was 5.26% higher in inter hospital transfer group. Kaplan Meier Survival analysis showed that the likelihood of survival at five years was 83% for direct admission vs 77.3% for inter hospital transfer with P value < 0.01. Additionally, one month mortality was significantly higher among inter hospital transfer group. Conclusion In all the cohort of patients, in-hospital mortality, and five years mortality was significantly higher in inter hospital transfer group compared to direct admission group. Conflict of Interest non

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