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August 16, 2005JAMA

Relationship Between Time of Day, Day of Week, Timeliness of Reperfusion, and In-Hospital Mortality for Patients With Acute ST-Segment Elevation Myocardial Infarction

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Why the study?

Does hospital arrival during off-hours increase time to reperfusion and in-hospital mortality in patients with STEMI?

Population

102,086 patients with ST-segment elevation myocardial infarction treated with fibrinolytic therapy or…

Comparison

Hospital arrival during off-hours vs Hospital arrival during regular hours

Design

Cohort

Follow-up

In-hospital

Authors

DMDavid J. Magid

Discussion

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Overview

May warrant enhanced off-hours STEMI systems; leaves open causality and generalizability.

Structured PICO

Does hospital arrival during off-hours increase time to reperfusion and in-hospital mortality in patients with STEMI?

P
Population
102,086 patients with ST-segment elevation myocardial infarction (STEMI) treated with fibrinolytic therapy (n=68,439) or percutaneous coronary intervention (PCI) (n=33,647) from 1999 through 2002.
I
Intervention
Hospital arrival during off-hours (weekdays 5 pm-7 am and weekends)
C
Comparator
Hospital arrival during regular hours (weekdays, 7 am-5 pm)
O
Outcome
Geometric mean door-to-drug time for fibrinolytic therapy, door-to-balloon time for PCI, and all-cause in-hospital mortalityhard clinical

STEMI presentation during off-hours is associated with delayed primary PCI and increased in-hospital mortality, highlighting the need for timely off-hours reperfusion systems.

Cite This Study

David J. Magid (2005) studied this question.

synapsesocial.com/papers/69f69258c00b229c773124f0https://doi.org/10.1001/jama.294.7.803
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