Key result
Off-hour admission for AMI is linked to ~85% higher in-hospital MACE risk.
Why the study?
In China, only on-duty cardiologists are available on more than 100 weekends or holidays, prompting an evaluation of the impact of admission time on MACEs in patients with AMI.
Observational
Answers are grounded in this paper and cite their sources.
Off-hour AMI admission was associated with higher MACE risk; leaves open whether staffing changes would reduce events.
BACKGROUND: In China, on more than 100 weekends or holidays, only on-duty cardiologists are available during admissions. This study aimed to analyze the impact of admission time on major adverse cardiovascular events (MACEs) in patients with acute myocardial infarction (AMI). METHODS: This prospective observational study enrolled patients with AMI between October 2018 and July 2019. The patients were assorted into off-hour (admitted on weekends or national holidays) and on-hour groups. The outcome was MACEs at admission and 1 year after discharge. Multivariate regression analysis showed that age (HR = 1.047, 95% CI: 1.021-1.073), blood glucose level (HR = 1.029, 95% CI: 1.009-1.050), multivessel disease (HR = 1.904, 95% CI: 1.074-3.375), and off-hour hospital admission (HR = 1.849, 95% CI: 1.125-3.039) were all independent risk factors for in-hospital MACEs, while percutaneous coronary intervention (HR = 0.210, 95% CI: 0.147-0.300) and on-hour admission (HR = 0.723, 95% CI: 0.532-0.984) were protective factors for MACEs 1 year after discharge. CONCLUSION: The "off-hour effect" still existed in patients with AMI, and the risk of MACEs in the hospital and 1 year after discharge was higher for off-hour admission.
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Zhang et al. (2023) conducted an observational in Acute myocardial infarction. Off-hour hospital admission (weekends or national holidays) vs. On-hour hospital admission was evaluated on Major adverse cardiovascular events (MACEs) in-hospital and at 1 year after discharge (HR 1.849, 95% CI 1.125-3.039, p=<0.05). Off-hour admission increased in-hospital MACE risk in AMI patients (HR 1.849; 95% CI 1.125-3.039), while on-hour admission lowered 1-year post-discharge MACE risk (HR 0.723; 95% CI 0.532-0.984).
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