Mortality differences in acute myocardial infarction patients in the Netherlands: The weekend-effect.

Autor: Eindhoven DC; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands., Wu HW; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands., Kremer SWF; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands., van Erkelens JA; Vektis B.V., Zeist, The Netherlands., Cannegieter SC; Department of Epidemiology, Leiden University Medical Center, Leiden, The Netherlands., Schalij MJ; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: M.J.Schalij@lumc.nl., Borleffs CJW; Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: American heart journal [Am Heart J] 2018 Nov; Vol. 205, pp. 70-76. Date of Electronic Publication: 2018 Aug 16.
DOI: 10.1016/j.ahj.2018.07.015
Abstrakt: Objective: Several studies have shown that patients admitted with an acute myocardial infarction during the weekends have a higher mortality rate than those admitted during weekdays, possibly attributable to less trained personnel available and a lower use of medical procedures. The current study aimed to assess this ‘weekend-effect’ in a nationwide registry.
Methods: In the Netherlands, all inhabitants are, by law, obliged to have health insurance and all claim data are centrally registered. In 2012 and 2013, all national diagnose-codings of STEMI and NSTEMI patients were acquired. One-year mortality rates and treatment with percutaneous coronary intervention (PCI) were compared between weekdays and weekends (holidays included).
Results: In total, 59,534 patients (67 ± 13 years, 39,545(66%) male) were included of whom 33,904(57%) had a NSTEMI. Overall 6857(12%) patients died in the year following the acute myocardial infarction registration. In STEMI patients, no differences in one-year mortality rates were observed between admission on weekdays or weekends. In NSTEMI patients, one-year mortality was higher in those admitted during weekends (weekdays 11% versus weekends 13%, P < .001). Furthermore, STEMI patients admitted during weekends were more often treated with PCI (weekdays 77% versus weekends 81%, P < .001). Conversely, NSTEMI patients admitted during weekends were less often treated with PCI (weekdays 35% versus weekends 32%, P < .001).
Conclusion: Differences in treatment and mortality rates exist between acute myocardial infarction patients admitted during weekdays and weekends. NSTEMI patients admitted during weekends are less often treated with PCI and have a higher mortality rate than patients admitted during weekdays.
(© 2018 Published by Elsevier Inc.)
Databáze: MEDLINE
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