The impact of time and day on the presentation of acute coronary syndromes
Key result
Patients presenting with acute coronary syndromes on weekends were significantly more likely to have a STEMI compared to those presenting on weekdays (19.3% vs 11.8%).
Why the study?
Does the time and day of admission affect the distribution of ACS types in patients presenting to the hospital?
Population
1,946 consecutive nontransfer acute coronary syndrome admissions to a tertiary-care academic center
Comparison
Admission on nights and weekends vs Admission on days and weekdays
Design
Cohort
Authors
Discussion
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Member takes
Implication
Weekend ACS presentations associated with higher STEMI rates; leaves open whether staffing models should account for day-of-week variation.
Study Design
Type
Cohort (n=1,946)
Multicenter
No
Structured PICO
Does the time and day of admission affect the distribution of ACS types in patients presenting to the hospital?
P
Population
1,946 consecutive nontransfer acute coronary syndrome (ACS) admissions (1999-2004) to a tertiary-care academic center
I
Intervention
Admission on nights (6 P.M.-6 A.M.) and weekends (Friday 6 P.M.-Monday 6 A.M.)
C
Comparator
Admission on days and weekdays
O
Outcome
Distribution of the types of ACS and clinical presentations (proportion of STEMI and AMI)
Main Result
Absolute Event Rate: 19.3% vs 11.8%
p-value: p=<0.001
Patients presenting with ACS on nights and weekends are more likely to have an AMI, driven by an increased proportion of STEMI, which has implications for healthcare staffing and clinical care paradigms.
Limitations
- Single center study at an academic tertiary-care setting may not be representative of other environments
- Excluded transfer patients from other hospitals
- Retrospective design
Cite This Study
LaBounty et al. (2006) conducted a cohort in Acute coronary syndromes (n=1,946). Weekend presentation vs. Weekday presentation was evaluated on Proportion of ACS patients presenting with STEMI (p=<0.001). Patients presenting with acute coronary syndromes on weekends were significantly more likely to have a STEMI compared to those presenting on weekdays (19.3% vs 11.8%).