PMID- 23737507
OWN - NLM
STAT- MEDLINE
DCOM- 20150331
LR  - 20131029
IS  - 1460-2393 (Electronic)
IS  - 1460-2393 (Linking)
VI  - 106
IP  - 11
DP  - 2013 Nov
TI  - The advantages of a consultant led primary percutaneous coronary intervention 
      service on patient outcome.
PG  - 989-94
LID - 10.1093/qjmed/hct132 [doi]
AB  - BACKGROUND: Mortality among emergency medical admissions has been reported to be 
      higher when patients are admitted to hospital at nights and weekends. AIM: We 
      studied the outcome of ST elevation myocardial infarction (STEMI) patients 
      presenting at different times to our centre with 24/7 primary percutaneous 
      coronary intervention (PPCI) service. METHODS: We divided all patients who 
      underwent PPCI between September 2009 and November 2011 into three groups 
      according to the time of admission as group 1: in-hours (0800-1800 h weekdays), 
      group 2: out-of-hours (1800- 0800 h weekdays) and group 3: weekends (Sat to Mon 
      0800-0800 h). RESULTS: A total of 605 (41.1%), 397 (27%) and 469 (31.9%) were 
      included in group 1, 2 and 3, respectively. Apart from cardiogenic shock (8.9%, 
      5.5% and 7.7%, P = 0.05) and door to balloon time (median 29, 33 and 36 min, P < 
      0.0001), there was no significant difference noted in the baseline and procedural 
      characteristics between the groups. In-hospital mortality (4.6%, 4.3% and 5.3%, P 
      = 0.5), 30-day mortality (6.4%, 6.3% and 7%, P = 0.7), 30-day stent thrombosis 
      (0.8%, 0.8% and 0.2%, P = 0.1) and 1-year mortality (10.7%, 10.8% and 9.8%, P = 
      0.7) were no difference between the groups. On logistic regression analysis, 
      out-of-hours and weekend admissions were not found to be a predictor of both 
      30-day and 1-year mortality. CONCLUSION: In this consecutive series of patients 
      admitted to a high volume PPCI centre, there was no difference in mortality when 
      patients were admitted at different times. The involvement of senior medical 
      staff early in the patients' admission may have contributed to these consistent 
      outcomes.
FAU - Showkathali, Refai
AU  - Showkathali R
AD  - Department of Cardiology, The Essex Cardiothoracic Centre, Basildon, Essex SS16 
      5NL, UK. refais@gmail.com.
FAU - Davies, John R
AU  - Davies JR
FAU - Sayer, Jeremy W
AU  - Sayer JW
FAU - Kelly, Paul A
AU  - Kelly PA
FAU - Aggarwal, Rajesh K
AU  - Aggarwal RK
FAU - Clesham, Gerald J
AU  - Clesham GJ
LA  - eng
PT  - Journal Article
DEP - 20130603
PL  - England
TA  - QJM
JT  - QJM : monthly journal of the Association of Physicians
JID - 9438285
SB  - IM
MH  - After-Hours Care/*standards/statistics & numerical data
MH  - Aged
MH  - Aged, 80 and over
MH  - Angioplasty, Balloon, Coronary/adverse effects/mortality
MH  - *Consultants
MH  - Female
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - Male
MH  - Percutaneous Coronary Intervention/*standards/*statistics & numerical data
MH  - Shock, Cardiogenic/mortality/*therapy
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2013/06/06 06:00
MHDA- 2015/04/01 06:00
CRDT- 2013/06/06 06:00
PHST- 2013/06/06 06:00 [entrez]
PHST- 2013/06/06 06:00 [pubmed]
PHST- 2015/04/01 06:00 [medline]
AID - hct132 [pii]
AID - 10.1093/qjmed/hct132 [doi]
PST - ppublish
SO  - QJM. 2013 Nov;106(11):989-94. doi: 10.1093/qjmed/hct132. Epub 2013 Jun 3.