Updated News for Your Heart About the Graveyard Shift

June Chen, MD

On March 3, 2008, Health and Age News reported that hospitalized patients who go into cardiac arrest during the night or on the weekend are more likely to die than patients who suffer a cardiac arrest during the day. In the latest issue of the American Heart Association's journal, Circulation, researchers reported that people who are admitted to the hospital with acute myocardial infarction (or, heart attack) during the night or on weekends and holidays are not more likely to die while they are in the hospital.

The scientists analyzed a database of 62,814 patients admitted to 379 hospitals throughout the United States with acute myocardial infarction from July 2000 to September 2005. When they studied the 33,982 patients who arrived at the hospital during off-peak hours, they found that these patients were less likely to receive primary percutaneous coronary intervention (or, angioplasty, a procedure where a small balloon is used to open a clogged artery), but they were not more likely to die than patients who arrived during regular hours. They also found that patients who arrived in the off hours were more likely to be treated with drug therapies rather than surgical treatment. In-hospital mortality was not significantly affected by time of arrival to the hospital, even when taking into account the fact that off-hours heart attack patients who did undergo angioplasty waited longer than regular-hours patients to receive this intervention.

These results differ from those reported by previous studies which found higher in-hospital death rates for patients who arrived during off-peak hours, but the investigators suggest that these differences might be explained by the varied group of patients and hospitals analyzed in this study. Still, the differences in the type of treatment, as well as the timing of the treatment, received by heart attack patients who are admitted to the hospital at different hours of the day highlight the challenges of mobilizing healthcare resources at times when the available hospital staff is more limited.

Source
Jneid H, Fonarow GC, Cannon CP, et al. Impact of time of presentation on the care and outcomes of acute myocardial infarction. Circulation 2008; DOI: 10.1161/CIRCULATIONAHA.107.752113.

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