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Mortality Risk Higher For Heart Attack Patients Admitted at Night and During Weekends

First Posted: Jan 22, 2014 08:42 AM EST

The chances of death is higher and emergency treatment takes longer for heart attack victims who rush to the hospitals during the night or over the weekends when compared to people who are admitted during the regular hours, according to a new study.

The study published in the bmj.com revealed that patients with acute myocardial infarction who arrive at the hospital during the off-hours. Also the 'Door to balloon time' (the time from arrival to hospital to first balloon inflation) is longer at an emergency procedure.

Heart disease is the leading cause of death for both men and women. In the United State about 600,000 people die from heart disease i.e. 1 in 4 deaths. One of the most common heart diseases is the coronary heart disease (CAD) that is the cause of death for more than 385,000 people every year, source Centers for Disease Control and Prevention.

Studies conducted earlier have also shown that patients with acute myocardial infarction, who arrive at the hospital during the off hours, suffer the risk of high mortality when compared to with the regular hours.

In this study, researchers at the US Mayo clinic analysed the effects of off-hour presentation among heart attack patients.  They looked at the results of 48 studies that were done on 1,896,859 patients. The studies were carried out in U.S., Canada and Europe.

The researchers noticed that the patients who were admitted during the off hours had a five-fold increased risk of mortality than the patients who were admitted ruing the regular hours. This led to an extra 6,000 deaths every year in the US.

It was also seen that in those diagnosed with certain type of heart attacks, there was a 15 minutes delay in door to balloon time in people who came during the off hours. The researchers claim that this could soar the mortality rate by 10-15 percent.

The authors suggest that "increased mortality during off-hours is associated with factors that arise after presentation at hospital."

They emphasize on the need for further studies that look into the difference in the quality of care by time of day.

In an accompanying editorial, doctors at the University of Toronto argue that, "patients presenting during off-hours experience delays in urgent care and worse outcomes, and the gap seems to be increasing over time." The healthcare managers seeking to boost their hospital's performance for patients with acute myocardial infarction should focus on improving their off-hour care, with the goal of providing consistently high quality care 24 hours a day and seven days a week.

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