Overall cohort | Propensity score matched (PSM) cohort | |||||
---|---|---|---|---|---|---|
Transfer | Non-transfer | p Value | Transfer | Non-transfer | p Value | |
N=10 107 | N=30 375 | N=8427 | N=8427 | |||
Age (mean± SD) | 65.1±12.9 | 70.8±14.1 | <0.01 | 66.9±12.5 | 67.3±14.6 | 0.06 |
% Male | 7129 (70.5) | 18 809 (61.9) | <0.01 | 5684 (67.5) | 5634 (66.9) | 0.41 |
Private health insurance | 2599 (25.7) | 6406 (21.1) | <0.01 | 1969 (23.4) | 1995 (23.7) | 0.64 |
Principal diagnosis | ||||||
STEMI | 4175 (41.3) | 10 015 (33.0) | <0.01 | 3124 (37.1) | 3037 (36.0) | 0.16 |
NSTEMI | 5932 (58.7) | 20 360 (67.0) | 5303 (62.9) | 5390 (64.0) | ||
Cardiovascular history† | ||||||
PCI | 100 (1.0) | 388 (1.3) | 0.02 | 91 (1.1) | 76 (0.9) | 0.24 |
CABG | 14 (0.1) | 71 (0.2) | 0.07 | 13 (0.2) | 15 (0.2) | 0.71 |
Heart failure | 1026 (10.2) | 6379 (21.0) | <0.01 | 239 (2.8) | 267 (3.2) | 0.21 |
AMI | 1378 (13.6) | 4626 (15.2) | <0.01 | 119 (1.4) | 145 (1.7) | 0.11 |
Unstable angina | 2044 (20.2) | 7374 (24.3) | <0.01 | 394 (4.7) | 427 (5.1) | 0.24 |
Chronic atherosclerosis | 5776 (57.2) | 22 254 (73.3) | <0.01 | 3216 (38.2) | 3140 (37.3) | 0.23 |
Valvular heart disease | 439 (4.34) | 2752 (9.06) | <0.01 | 263 (3.1) | 324 (3.8) | 0.01 |
Comorbidities† | ||||||
Hypertension | 6027 (59.6) | 20 013 (65.9) | <0.01 | 4412 (52.4) | 4444 (52.7) | 0.62 |
Stroke | 183 (0.5) | 850 (2.80) | <0.01 | 38 (0.5) | 38 (0.5) | 1.00 |
Cerebrovascular disease | 255 (2.5) | 1211 (4.0) | <0.01 | 75 (0.9) | 76 (0.9) | 0.94 |
Renal failure | 693 (6.9) | 3877 (12.8) | <0.01 | 149 (1.8) | 153 (1.8) | 0.82 |
Chronic obstructive airway disease | 666 (6.6) | 3409 (11.2) | <0.01 | 439 (5.2) | 449 (5.3) | 0.73 |
Pneumonia | 271 (2.7) | 1596 (5.3) | <0.01 | 75 (0.9) | 81 (1.0) | 0.63 |
Diabetes | 1706 (16.9) | 6328 (20.8) | <0.01 | 1134 (13.5) | 1117 (13.3) | 0.70 |
Dementia | 207 (2.1) | 2430 (8.0) | <0.01 | 86 (1.0) | 111 (1.3) | 0.07 |
Hemiplegia, paraplegia, paralysis, and functional disability | 474 (4.7) | 2417 (8.0) | <0.01 | 153 (1.8) | 169 (2.0) | 0.37 |
Peripheral vascular disease | 789 (7.8) | 3342 (11.0) | <0.01 | 212 (2.5) | 228 (2.7) | 0.44 |
Metastatic cancer | 214 (2.1) | 1025 (3.4) | <0.01 | 58 (0.7) | 71 (0.8) | 0.25 |
Major psychiatric disorder | 88 (0.9) | 398 (1.3) | <0.01 | 45 (0.5) | 45 (0.5) | 1.00 |
Chronic liver disease | 84 (0.8) | 349 (1.2) | <0.01 | 43 (0.5) | 42 (0.5) | 0.91 |
Acute complications | ||||||
Mechanical complication of AMI | 8 (0.1) | 61 (0.2) | 0.01 | 8 (0.1) | 9 (0.1) | 0.81 |
Cardiogenic shock | 74 (0.7) | 611 (2.0) | <0.01 | 71 (0.8) | 76 (0.9) | 0.68 |
Cardiac arrest | 138 (1.4) | 800 (2.6) | <0.01 | 124 (1.5) | 116 (1.4) | 0.60 |
Ventricular arrhythmia (VT/VF) | 234 (2.3) | 976 (3.2) | <0.01 | 194 (2.3) | 197 (2.3) | 0.88 |
Acute renal failure | 144 (1.4) | 1658 (5.5) | <0.01 | 143 (1.7) | 154 (1.8) | 0.52 |
Ischaemic stroke | 10 (0.1) | 192 (0.6) | <0.01 | 10 (0.1) | 10 (0.1) | 1.00 |
Major bleeding | 157 (1.6) | 1318 (4.3) | <0.01 | 156 (1.9) | 168 (2.0) | 0.50 |
Heart failure | 739 (7.3) | 5439 (17.9) | <0.01 | 731 (8.7) | 736 (8.7) | 0.89 |
Presenting hospital characteristics | ||||||
Hospital region | ||||||
Major city area | 6746 (66.8) | 23 934 (78.8) | <0.0001 | 5459 (64.8) | 5489 (65.1) | 0.63 |
Regional hospital | 3361 (33.3) | 6441 (21.2) | <0.0001 | 2968 (35.2) | 2938 (35.9) | |
Hospital type | ||||||
Tertiary referral hospital | 5783 (57.2) | 21 539 (70.9) | <0.0001 | 4946 (58.7) | 4953 (58.8) | 0.32 |
Large hospital | 2799 (27.7) | 4235 (14.5) | 2115 (25.1) | 2171 (25.8) | ||
Medium hospital | 826 (8.2) | 1970 (6.5) | 784 (9.3) | 735 (8.7) | ||
Small acute hospital | 340 (3.4) | 373 (1.2) | 229 (2.7) | 248 (0.9) | ||
Private hospital | 359 (3.6) | 2258 (7.4) | 353 (4.2) | 320 (3.2) | ||
Revascularisation (PCI±CABG) Capable Hospital | 2269 (22.5) | 17 966 (59.2) | <0.01 | 2260 (26.8) | 2181 (25.9) | 0.17 |
*Only selected baseline characteristics are presented. Refer to the online supplementary appendix for detail description of all variables included.
†Cardiovascular history and comorbidities as recorded during index admission or during any admissions occurring in the 12 months prior to index hospitalisation. PCI and CABG are recorded only at the time of the procedure. On subsequent admissions the underlying disease process (ie, coronary disease) is typically recorded (depicted in this table under chronic atherosclerosis).
AMI, acute myocardial infarction; CABG, coronary artery bypass grafting; NSTEMI, non-ST elevation myocardial infarction; PCI, percutaneous coronary intervention; STEMI, ST-elevation myocardial infarction; VF, ventricular fibrillation; VT, ventricular tachycardia.