Access to cardiac catheterization services in a rural-urban setting in northern British Columbia: Examining the impact of time-delay to PCI on patient outcomes and whether the sickest go the quickest..

This thesis describes the results of a study exploring patient access to percutaneous coronary intervention (PCI) in a rural-urban setting in northern British Columbia, Canada. It specifically examines: 1) whether longer times to treatment (>120 mins) are associated with higher adverse outcomes (death, re-infarction, heart failure, or stroke) in the UA, NSTEMI and STEMI groups within 30-days and 1-year of hospital admission and 2) whether patients most at risk using the Global Registry of Acute Coronary Events (GRACE) risk score receive PCI faster in the UA, NSTEMI, and STEMI groups. Data were collected through retrospective medical chart reviews. Times to treatment and adverse outcomes data are provided although quantitative analysis of this association was not performed. It was determined that the only significant predictor of time to PCI was age and patients were not transferred according to their risk status. Thus it can be concluded that this exploratory study provided valuable real-time feedback for cardiac services in this region and is a basis for further longitudinal investigation in this area. --Leaf ii.