Higher Mortality for Weekend Myocardial Infarctions
Rate higher due to fewer invasive cardiac procedures
WEDNESDAY, March 14 (HealthDay News) -- Acute myocardial infarction patients who are admitted on the weekends have a higher 30-day mortality rate than those admitted during the week, largely due to fewer invasive cardiac procedures being performed, researchers report in the March 15 issue of the New England Journal of Medicine.
William J. Kostis, Ph.D., from the University of Medicine and Dentistry of New Jersey in New Brunswick, and colleagues compared differences in mortality in 231,164 patients admitted for a first acute myocardial infarction in New Jersey from 1987 to 2002 based on weekday or weekend admission.
The researchers found that patients admitted on weekends were less likely to undergo invasive cardiac procedures. From 1999-2002, the 30-day mortality was higher for patients admitted on weekends (12.9 versus 12.0 percent), which started the day after admission through one year later. The difference in 30-day mortality remained significant after adjustment for several variables (hazard ratio 1.048) but became non-significant after also adjusting for invasive cardiac procedures (hazard ratio 1.023).
The study "shows that there is a specific way to improve cardiac care in hospitals: provide better treatment for acute myocardial infarction on weekends," Donald A. Redelmeier, M.D., from Sunnybrook Health Sciences Centre and Chaim M. Bell, M.D., Ph.D., from St. Michael's Hospital, both in Toronto, Ontario, Canada, write in an accompanying editorial. "The goal is to improve patient care yet avoid excessive demands on clinicians and unaffordable premiums for payers."