More Heart Attack Patients Die in December

Reason why that month is associated with more deaths still a mystery to researchers

MONDAY, Oct. 3, 2005 (HealthDay News) -- People who have a heart attack in December are more likely to die than people who have heart attacks in other months, a new study finds.

Findings similar to this have blamed holiday understaffing, cold weather or uneven care for the anomaly. However, in this study, the researchers took these factors into account and still found more patients died in December compared with other months.

The report appears in the Oct. 4 issue of the Annals of Internal Medicine.

In the study, a research team led by Dr. James Jollis, a cardiologist at Duke University Medical Center, collected data on 127,959 Medicare patients hospitalized for heart attack between January 1994 and February 1996.

The researchers found that, while treatment was essentially the same for all the patients, 21.7 percent of those admitted to the hospital in December died, compared with 20.1 percent admitted to hospitals in other months.

"We found that the 30-day mortality of patients hospitalized with acute MI [heart attack] in December was higher than in other months, even after adjusting for patient, physician and hospital characteristics, and use of evidence-based therapies," the researchers wrote.

"Our findings highlight the need for further research into the mechanism of increased mortality in patients hospitalized in December, while ensuring continued emphasis on standardized care during holiday seasons for patients with acute MI," they concluded.

One expert thinks these findings confirm similar findings seen by his group. In addition, he recommends some precautions that people can take to reduce their risk of having a heart attack during the winter months.

"This paper is at least reassuring that standards of care do not diminish during the month of December," said Dr. Robert A. Kloner, director of research at the Heart Institute at Good Samaritan Hospital and professor of medicine in the cardiovascular division of the Keck School of Medicine, University of Southern California.

"The study further confirms our observation of increased cardiovascular mortality during the winter months," Kloner added. "Still, we are left with an unexplained higher mortality rate during the month of December, once the various multivariate analyses are performed and after adjusting for patient risk."

Kloner agrees that there is a need for more research into the mechanism of higher cardiac mortality in December. "Until we have definitive answers, there are some common-sense approaches," he said.

"Physicians can remind their patients not to delay the seeking of medical attention if they develop symptoms, to avoid running out of medications, to avoid overindulgence of food, salt, fatty foods and alcohol, and avoid exposure to extreme cold, and avoid exposure to particulate pollutants, which can be generated from wood-burning fireplaces -- often common during the holiday season," Kloner said.

More information

The American Heart Association can tell you more about heart attacks.

SOURCES: Robert A. Kloner, M.D., Ph.D., director, research, Heart Institute, Good Samaritan Hospital, Los Angeles, and professor, medicine, cardiovascular division, Keck School of Medicine, University of Southern California, Los Angeles; Oct. 4, 2005, Annals of Internal Medicine
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