PMID- 22705606
OWN - NLM
STAT- MEDLINE
DCOM- 20121107
LR  - 20211021
IS  - 0975-4466 (Electronic)
IS  - 0256-4947 (Print)
IS  - 0256-4947 (Linking)
VI  - 32
IP  - 4
DP  - 2012 Jul-Aug
TI  - Are acute coronary syndrome patients admitted during off-duty hours treated 
      differently? An analysis of the Saudi Project for Assessment of Acute Coronary 
      Syndrome (SPACE) study.
PG  - 366-71
AB  - BACKGROUND AND OBJECTIVES: It is often suggested that acute coronary syndrome 
      (ACS) patients admitted during off-duty hours (OH) have a worse clinical outcome 
      than those admitted during regular working hours (RH). Our objective was to 
      compare the management and hospital outcomes of ACS patients admitted during OH 
      with those admitted during RH. DESIGN AND SETTING: Prospective observational 
      study of ACS patients enrolled in the Saudi Project for Assessment of Acute 
      Coronary Syndrome study from December 2005 to December 2007. PATIENTS AND 
      METHODS: ACS patients with available date and admission times were included. RH 
      were defined as weekdays, 8 AM-5 PM, and OH was defined as weekdays 5 PM-8 AM, 
      weekends, during Eid (a period of several days marking the end of two major 
      Islamic holidays), and national days. RESULTS: Of the 2825 patients qualifying 
      for this analysis, 1016 (36%) were admitted during RH and 1809 (64%) during OH. 
      OH patients were more likely to present with heart failure and ST elevation 
      myocardial infarction (STEMI) and to receive fibrinolytic therapy, but were less 
      likely to undergo primary percutaneous coronary interventions (PCI). The median 
      door to balloon time was significantly longer (P<.01) in OH patients (122 min) 
      than in RH patients. No differences were observed in hospital outcomes including 
      mortality between the two groups, except for higher heart failure rates in OH 
      patients (11.1% vs 7.2%, P<.001). CONCLUSIONS: STEMI patients admitted during OH 
      were disadvantaged with respect to use and speed of delivery of primary PCI but 
      not fibrinolytic therapy. Hospitals providing primary PCI during OH should aim to 
      deliver it in a timely manner throughout the day.
FAU - Al Faleh, Hussam F
AU  - Al Faleh HF
AD  - College of Medicine, King Saud University, Riyadh, Saudi Arabia. 
      halfaleh@ksu.edu.sa
FAU - Thalib, Lukman
AU  - Thalib L
FAU - AlHabib, Khalid F
AU  - AlHabib KF
FAU - Ullah, Anhar
AU  - Ullah A
FAU - AlNemer, Khalid
AU  - AlNemer K
FAU - AlSaif, Shukri M
AU  - AlSaif SM
FAU - Taraben, Amir N
AU  - Taraben AN
FAU - Malik, Asif
AU  - Malik A
FAU - Abuosa, Ahmed M
AU  - Abuosa AM
FAU - Mimish, Layth A
AU  - Mimish LA
FAU - Hersia, Ahmad Salah
AU  - Hersia AS
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - Saudi Arabia
TA  - Ann Saudi Med
JT  - Annals of Saudi medicine
JID - 8507355
RN  - 0 (Fibrinolytic Agents)
SB  - IM
MH  - Acute Coronary Syndrome/physiopathology/*therapy
MH  - Adult
MH  - After-Hours Care/methods
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/methods
MH  - Delivery of Health Care/*methods/standards
MH  - Female
MH  - Fibrinolytic Agents/therapeutic use
MH  - Heart Failure/epidemiology/*therapy
MH  - Hospital Mortality
MH  - Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/epidemiology/*therapy
MH  - Personnel Staffing and Scheduling
MH  - Prospective Studies
MH  - Saudi Arabia
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC6081017
EDAT- 2012/06/19 06:00
MHDA- 2012/11/08 06:00
PMCR- 2012/07/01
CRDT- 2012/06/19 06:00
PHST- 2012/06/19 06:00 [entrez]
PHST- 2012/06/19 06:00 [pubmed]
PHST- 2012/11/08 06:00 [medline]
PHST- 2012/07/01 00:00 [pmc-release]
AID - 12-366 [pii]
AID - asm-4-366 [pii]
AID - 10.5144/0256-4947.2012.366 [doi]
PST - ppublish
SO  - Ann Saudi Med. 2012 Jul-Aug;32(4):366-71. doi: 10.5144/0256-4947.2012.366.