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Does on‐ versus off‐hours presentation impact in‐hospital outcomes of ST‐segment elevation myocardial infarction patients transferred to a tertiary care center?
Author(s) -
Gonzalez Manuel A.,
BenDor Itsik,
Wakabayashi Kohei,
Maluenda Gabriel,
Gaglia Michael A.,
Hanicholas N.,
Delhaye Cedric,
Collins Sara D.,
Syed Asmir I.,
Mitulescu Lavinia P.,
Torguson Rebecca,
Suddath William O.,
Lindsay Joseph,
Pichard Augusto D.,
Satler Lowell F.,
Waksman Ron
Publication year - 2010
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22515
Subject(s) - medicine , myocardial infarction , tertiary care , percutaneous coronary intervention , emergency medicine , cardiology , cardiac catheterization
Objectives : To determine whether in‐hospital outcome differs for transferred patients with ST‐segment elevation myocardial infarction (STEMI) presenting during business (ON) hours vs. after (OFF) hours. Background : Door‐to‐device (DTD) time is a prognostic factor in patients with STEMI and is longer during OFF hours. However, the in‐hospital mortality is controversial. Methods : This registry study included 786 consecutive patients with STEMI referred for primary percutaneous coronary intervention to a tertiary care center with an on‐site cardiac catheterization team 24 hrs a day/7 days (24/7) a week. ON hours were defined as weekdays 8 a.m. to 5 p.m., while OFF hours were defined as all other times, including holidays. The primary outcomes were in‐hospital death, reinfarction, and length of stay (LOS). Results : ON hours (29.5%, n = 232) and OFF hours (70.5%, n = 554) groups had similar demographic and baseline characteristics. A significantly higher proportion of patients presenting ON hours had a DTD time ≤120 min compared to OFF hours patients (32.6% vs. 22.1%, P = 0.007). The rates of in‐hospital death (8.2% vs. 6%), reinfarction (0% vs. 1.1%), and mean LOS (5.7 ± 6 vs. 5.7 ± 5) were not significantly different in the ON vs. OFF hours groups, all P = nonsignificant. Conclusion : In a tertiary care center with an on‐site cardiac catheterization team 24/7, there are no differences in in‐hospital outcomes of transferred patients with STEMI during ON vs. OFF hours. © 2010 Wiley‐Liss, Inc.