Key result
Off-hours admission for patients with STEMI undergoing primary PCI did not significantly increase in-hospital mortality compared to regular hours admission (6.5% vs 1.9%, p=0.146).
Why the study?
Does off-hours admission increase in-hospital death or delay reperfusion therapy in patients with STEMI undergoing primary PCI?
Cohort (n=289)
No
Does off-hours admission increase in-hospital death or delay reperfusion therapy in patients with STEMI undergoing primary PCI?
Absolute Event Rate: 6.5% vs 1.9%
p-value: p=0.146
Off-hours admission for STEMI patients undergoing primary PCI at a 24/7 capable center in China did not result in delayed reperfusion therapy or increased in-hospital mortality compared to regular hours.
Off-hours STEMI admission was not associated with higher mortality at this 24/7 center; hypothesis-generating and requires confirmation in larger cohorts.
OBJECTIVE: To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction (STEMI). METHODS: All patients with STEMI who were admitted to the emergency department and underwent primary percutaneous coronary intervention at Peking University People's Hospital between April 2012 and March 2015 were included. We examined differences in clinical characteristics, total ischemic time, and in-hospital death between patients admitted during off-hours and those admitted during regular hours. Multivariate logistic regression was used to estimate the relationship between off-hours admission and clinical outcome. RESULTS: < 0.05). Door-to-balloon (DTB) time, the rate of DTB time ≤ 90 min, and in-hospital death were comparable between groups. Multivariate logistic regression showed that age and creatinine level, but not off-hours admission, were associated independently with increased in-hospital death. CONCLUSIONS: Off-hours admission did not result in delayed reperfusion therapy or increased in-hospital mortality in patients with STEMI. Further efforts should focus on identifying pivotal factors associated with the pre-hospital and in-hospital delay of reperfusion therapy, and implementing quality improvement initiatives for reperfusion programs.
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Zhu et al. (2016) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=289). Off-hours admission vs. Regular hours admission was evaluated on In-hospital death (p=0.146). Off-hours admission for patients with STEMI undergoing primary PCI did not significantly increase in-hospital mortality compared to regular hours admission (6.5% vs 1.9%, p=0.146).