Heart Attack Patients Treated at Night or on the Weekends have a 13 Percent Increased Risk of Dying

The constant chaos of an emergency room can leave patients concerned about when they may get proper treatment.

Now, a new study published in the journal Circulation: Cardiovascular Quality and Outcomes found that treatment and survival can be greatly impacted by time of arrival.

Researchers at the Northshore University Health System in Evanston, Ill., discovered that heart attack patients were 13 percent more likely to die if they arrived at the hospital during holiday or after-hours when compared to those treated during typical business hours.

"When a heart attack patient comes to the emergency department at 1 a.m., the emergency staff activate the pagers. Doctors need to drive to the hospital, get things set up in the cath lab, and it takes time," said Jorge Saucedo, M.D., lead author of the study and chief of cardiology and co-director of the Cardiovascular Institute at Northshore University Health System in Evanston, Ill, via Health Day.

For patients who needed angioplasty, they typically received the procedure 16 minutes faster during regular business hours than those who came during the weekends, after hours or on holidays. Furthermore, researchers also found lower in-hospital deaths and improved door-to-needle times, overall, during regular work day times.

For the study, researchers compared the care of 27,270 STEMI patients who arrived after hours to 15,972 STEMI patients who arrived during regular business hours between January 2007 and September 2012 at 447 U.S. hospitals.

The American Heart Association's guidelines recommend that STEMI patients be treated for angioplasty in 90 minutes or less. However, study findings revealed that about 88 percent of patients who arrived during regular weekday hours were treated in the 90 minute range, while only 79 percent of those who arrived during after-hours were.

Researchers said they believe that slower response time during after-hours may be due to smaller numbers of staff.

"Slower door-to-balloon times for people who arrived at the hospital during off hours is likely due to staffing," Saucedo added, via Health day. "In the middle of the night, the hospital catheterization lab, where angioplasty and other artery-opening procedures are performed, is closed,"
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