Off-Hours Myocardial Infarction More Likely to Be Fatal
Atsushi Sorita, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues conducted a systematic review and meta-analysis to assess the effect of off-hour presentation on door-to-balloon times and mortality in patients with acute MI.
The researchers found that patients presenting with acute MI during off-hours had significantly higher short-term mortality (odds ratio, 1.06). Patients presenting with ST-segment elevation MI during off-hours were less likely to receive percutaneous coronary intervention within 90 minutes (odds ratio, 0.40) and had door-to-balloon times that were 14.8 minutes longer.
"The pooled results confirmed the presence of a 5 percent relative increase in mortality (both in-hospital and 30-day) as well as a delay of nearly 15 minutes in door-to-balloon time for patients presenting during off-hours," write the authors of an accompanying editorial. "Future studies should try to identify specific deficits in the care pathway during off-hours, allowing differences in outcomes to be linked to differences in processes."