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Mortality Higher for MI Admissions at Night, on Weekends — Physician’s First Watch

Medical News |
January 22, 2014

Mortality Higher for MI Admissions at Night, on Weekends

By Amy Orciari Herman

A BMJ meta-analysis adds to the evidence that patients who present with acute myocardial infarction at night or on weekends (i.e., off-hours) fare worse than those presenting on weekdays during regular hours.

The analysis included 48 fair-quality studies comprising nearly 1.9 million adults with acute MI. Overall, patients who presented during off-hours had higher in-hospital or 30-day mortality than those who presented during regular hours (odds ratio, 1.06). In addition, those who presented with ST-segment-elevation MI during off-hours were less likely to undergo percutaneous coronary intervention within 90 minutes, relative to those presenting during regular hours. Door-to-balloon time was about 15 minutes longer during nights and weekends.

The odds ratio for mortality associated with off-hours presentation was lower in a subanalysis of North American studies, at 1.03. Still, that would translate to roughly 1900 excess deaths annually, the authors estimate.

Reader Comments (1)

Alaa Bedeir Physician, Internal Medicine, Private

I agree that mortality rate ratio very high during weekend and after 2pm day work

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