Literature DB >> 20882649

Does on- versus off-hours presentation impact in-hospital outcomes of ST-segment elevation myocardial infarction patients transferred to a tertiary care center?

Manuel A Gonzalez1, Itsik Ben-Dor, Kohei Wakabayashi, Gabriel Maluenda, Michael A Gaglia, Nicholas N Hanna, Cedric Delhaye, Sara D Collins, Asmir I Syed, Lavinia P Mitulescu, Rebecca Torguson, William O Suddath, Joseph Lindsay, Augusto D Pichard, Lowell F Satler, Ron Waksman.   

Abstract

OBJECTIVES: To determine whether in-hospital outcome differs for transferred patients with ST-segment elevation myocardial infarction (STEMI) presenting during business (ON) hours vs. after (OFF) hours.
BACKGROUND: Door-to-device (DTD) time is a prognostic factor in patients with STEMI and is longer during OFF hours. However, the in-hospital mortality is controversial.
METHODS: This registry study included 786 consecutive patients with STEMI referred for primary percutaneous coronary intervention to a tertiary care center with an on-site cardiac catheterization team 24 hrs a day/7 days (24/7) a week. ON hours were defined as weekdays 8 a.m. to 5 p.m., while OFF hours were defined as all other times, including holidays. The primary outcomes were in-hospital death, reinfarction, and length of stay (LOS).
RESULTS: ON hours (29.5%, n = 232) and OFF hours (70.5%, n = 554) groups had similar demographic and baseline characteristics. A significantly higher proportion of patients presenting ON hours had a DTD time ≤120 min compared to OFF hours patients (32.6% vs. 22.1%, P = 0.007). The rates of in-hospital death (8.2% vs. 6%), reinfarction (0% vs. 1.1%), and mean LOS (5.7 ± 6 vs. 5.7 ± 5) were not significantly different in the ON vs. OFF hours groups, all P = nonsignificant.
CONCLUSION: In a tertiary care center with an on-site cardiac catheterization team 24/7, there are no differences in in-hospital outcomes of transferred patients with STEMI during ON vs. OFF hours.
© 2010 Wiley-Liss, Inc.

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Year:  2010        PMID: 20882649     DOI: 10.1002/ccd.22515

Source DB:  PubMed          Journal:  Catheter Cardiovasc Interv        ISSN: 1522-1946            Impact factor:   2.692


  3 in total

1.  Association between prehospital electrocardiogram use and patient home distance from the percutaneous coronary intervention center on total reperfusion time in ST-segment-elevation myocardial infarction patients: a retrospective analysis from the national cardiovascular data registry.

Authors:  Bryn E Mumma; Michael C Kontos; S Andrew Peng; Deborah B Diercks
Journal:  Am Heart J       Date:  2014-04-04       Impact factor: 4.749

Review 2.  Off-hour presentation and outcomes in patients with acute myocardial infarction: systematic review and meta-analysis.

Authors:  Atsushi Sorita; Adil Ahmed; Stephanie R Starr; Kristine M Thompson; Darcy A Reed; Larry Prokop; Nilay D Shah; M Hassan Murad; Henry H Ting
Journal:  BMJ       Date:  2014-01-21

3.  Influence of Admission Time on Health Care Quality and Utilization in Patients with Stroke: Analysis for a Possible July Effect and Weekend Effect.

Authors:  Chun-Yi Liu; Pei-Tseng Kung; Hui-Yun Chang; Yueh-Han Hsu; Wen-Chen Tsai
Journal:  Int J Environ Res Public Health       Date:  2021-11-24       Impact factor: 3.390

  3 in total

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