Depression Tied to Lower Priority of Care in Heart Attack

Patients with documented history triaged to longer waits for care

THURSDAY, March 3 (HealthDay News) -- Heart attack patients with a documented history of depression in their charts may be triaged to lower priority of care than patients with no documented history of depression, and they are more likely to have worse associated performance on quality indicators, according to research published online Feb. 28 in CMAJ, the journal of the Canadian Medical Association.

Clare L. Atzema, M.D., of the Sunnybrook Health Sciences Centre in Toronto, and colleagues retrospectively analyzed 6,874 patients with a history of myocardial infarction to determine whether a history of depression was associated with a lower-priority emergency department triage score and subsequent worse quality of care in acute myocardial infarction patients.

The researchers found that 10 percent of the myocardial infarction patients had a history of depression documented in their chart, and 39.1 percent of these patients were assigned a low-priority triage score, compared to 32.7 percent of patients with no charted history of depression. Between those with documented depression and no documented depression, the median door-to-electrocardiogram time was 20 and 17 minutes, respectively; the door-to-needle time was 53 and 37 minutes, respectively; and the door-to-balloon time was 251 and 110 minutes, respectively.

"Patients with acute myocardial infarction who had a charted history of depression were more likely to receive a low-priority emergency department triage score than those with other comorbidities and to have worse associated performance on quality indicators in acute myocardial infarction care," the authors write.

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