{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:12:00Z","timestamp":1793502720156,"version":"4.5.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"25","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2014,6,24]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Interhospital transfer of patients with ST-elevation myocardial infarction (STEMI) for primary percutaneous coronary intervention (PPCI) is associated with longer delays to reperfusion, related in part to turnaround (\u201cdoor in\u201d to \u201cdoor out,\u201d or DIDO) time at the initial hospital. As part of a systematic, province-wide evaluation of STEMI care, we examined DIDO times and associations with patient, hospital, and process-of-care factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We performed medical chart review for STEMI patients transferred for PPCI during a 6-month period (October 1, 2008, through March 31, 2009) and linked these data to ambulance service databases. Two core laboratory cardiologists reviewed presenting ECGs to identify left bundle-branch block and, in the absence of left bundle-branch block, definite STEMI (according to both cardiologists) or an ambiguous reading. Median DIDO time was 51 minutes (25th to 75th percentile: 35\u201382 minutes); 14.1% of the 988 patients had a timely DIDO interval (\u226430 minutes as recommended by guidelines). The data-to-decision delay was the major contributor to DIDO time. Female sex, more comorbidities, longer symptom duration, arrival by means other than ambulance, arrival at a hospital not exclusively transferring for PPCI, arrival at a center with a low STEMI volume, and an ambiguous ECG were independently associated with longer DIDO time. When turnaround was timely, 70% of patients received timely PPCI (door-to-device time \u226490 minutes) versus 14% if turnaround was not timely (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Benchmark DIDO times for STEMI patients transferred for PPCI were rarely achieved. Interventions aimed at facilitating the transfer decision, particularly in cases of ECGs that are difficult to interpret, are likely to have the best impact on reducing delay to reperfusion.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.113.007130","type":"journal-article","created":{"date-parts":[[2014,4,18]],"date-time":"2014-04-18T06:50:00Z","timestamp":1397803800000},"page":"2653-2660","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":31,"title":["Transfer of Patients With ST-Elevation Myocardial Infarction for Primary Percutaneous Coronary Intervention"],"prefix":"10.1161","volume":"129","author":[{"given":"Laurie J.","family":"Lambert","sequence":"first","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Brown","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy J.","family":"Boothroyd","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Segal","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Maire","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Kouz","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dave","family":"Ross","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Harvey","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Rinfret","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongling","family":"Xiao","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Nasmith","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bogaty","sequence":"additional","affiliation":[{"name":"From the Cardiology Evaluation Unit, Institut national d\u2019excellence en sant\u00e9 et en services sociaux (INESSS), Montreal, Quebec, Canada (L.J.L., K.A.B., L.J.B., Y.X., P.B.); Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada (E.S.); Corporation d\u2019Urgences-sant\u00e9, Montreal, Quebec, Canada (E.S., D.R.); Centre hospitalier affili\u00e9 universitaire H\u00f4tel-Dieu de L\u00e9vis, L\u00e9vis, Quebec, Canada (S.M.); Centre hospitalier r\u00e9gional de Lanaudi\u00e8re, Joliette, Quebec, Canada (S.K.); Services..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0b013e3182742c84"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs215"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.481"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.862"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.111.033118"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.712"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.10.015"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(92)90133-8"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmva.2004.05.006"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.191099"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.110.959643"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.06.008"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.964270"},{"key":"e_1_3_4_15_2","first-page":"e40. Abstract 1","article-title":"Reliability of process measures of care of patients presenting with ST-elevation myocardial infarction (STEMI) abstracted by hospital health record librarians: results of a field evaluation in Quebec, Canada.","volume":"2","author":"Lambert L","year":"2009","unstructured":"Lambert L, Simard S, Carroll-Bilodeau C, Giguere M, Morin J, Boothroyd L, Bogaty P. Reliability of process measures of care of patients presenting with ST-elevation myocardial infarction (STEMI) abstracted by hospital health record librarians: results of a field evaluation in Quebec, Canada. Circ Cardiovasc Qual Outcomes. 2009;2:e40. Abstract 175.","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-6-201109200-00008"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.113.007130","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:32:50Z","timestamp":1715581970000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.113.007130"}},"subtitle":["A Province-Wide Evaluation of \u201cDoor-in to Door-Out\u201d Delays at the First Hospital"],"short-title":[],"issued":{"date-parts":[[2014,6,24]]},"references-count":15,"journal-issue":{"issue":"25","published-print":{"date-parts":[[2014,6,24]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.113.007130"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.113.007130","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,24]]},"assertion":[{"value":"2013-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-04-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-04-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}