PMID- 36720020
OWN - NLM
STAT- MEDLINE
DCOM- 20230202
LR  - 20230924
IS  - 1473-5830 (Electronic)
IS  - 0954-6928 (Linking)
VI  - 34
IP  - 2
DP  - 2023 Mar 1
TI  - ST elevation myocardial infarction - national trend analysis with mortality 
      differences in outcomes based on day of hospitalization.
PG  - 119-126
LID - 10.1097/MCA.0000000000001211 [doi]
AB  - BACKGROUND: Patientswho present with acute ST elevation myocardial infarction 
      (STEMI) need emergent revascularization. Our study aims to investigate the 
      outcomes in patients with STEMI admitted during weekends versus weekdays. 
      METHODS: We conducted a retrospective analysis of the nationwide inpatient sample 
      database. Patients with an admitting diagnosis of STEMI identified by the 
      International Classification of Disease code for the year 2016 were analyzed. A 
      weighted descriptive analysis was performed to generate national estimates. 
      Patients admitted over the weekend were compared to those admitted over the 
      weekday. Patients were stratified by demographic and clinical factors including 
      the Elixhauser comorbidity index. The primary outcome was in-hospital mortality 
      and secondary outcomes were percutaneous coronary intervention (PCI) utilization 
      rate, rate of transfer-out, length of stay (LOS), and total hospital charges. 
      Statistical analysis including linear and logistic regression was performed using 
      STATA. RESULTS: A total of 163 715 adult patients were admitted with STEMI, of 
      which 27.9% (45 635) were admitted over the weekend. There were 76.2% Caucasians, 
      9.3% African Americans, and 8.0% Hispanics. Mean age of the patients was 
      63.2 years (95% CI, 62.9-63.5) for the weekend group and 63.7 years (95% CI, 
      63.5-63.9) for weekday admissions. The majority of the patients in both groups 
      had Medicare (43.7% and 45.8% on weekends and weekdays, respectively; 
      P = 0.0047). After adjusting for age, sex, race, income, Elixhauser comorbidity 
      index, PCI use, hospital location, teaching status, and bed size, mortality was 
      not significantly different in weekend versus weekday admissions (odds ratios 
      1.04; P = 0.498; 95% CI, 0.93-1.16). There was no significant difference in mean 
      total charge per admission during the weekend versus weekday admissions ($107 093 
      versus $106 869; P = 0.99.) Mean LOS was 4.1 days for both groups (P = 0.81). 
      CONCLUSIONS: There were no significant differences in mortality, LOS, or total 
      hospital charge in STEMI patients being admitted during the weekend versus 
      weekdays.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Jha, Anil
AU  - Jha A
AD  - Department of Cardiovascular Medicine, St. Vincent Hospital, UMass Chan Medical 
      School, Worcester, Massachusetts.
FAU - Ojha, Chandra P
AU  - Ojha CP
AD  - Department of Medicine, Texas Tech University Health Sciences Center, El Paso, 
      Texas.
FAU - Bhattad, Pradnya Brijmohan
AU  - Bhattad PB
AD  - Department of Cardiovascular Medicine, St. Vincent Hospital, UMass Chan Medical 
      School, Worcester, Massachusetts.
FAU - Sharma, Ashish
AU  - Sharma A
AD  - Department of Internal Medicine, Yuma Regional Medical Center, Yuma, Arizona.
FAU - Thota, Ajit
AU  - Thota A
AD  - Department of Anesthesiology - Critical Care Medicine, Memorial Sloan Kettering 
      Cancer Center, New York.
FAU - Mishra, Ajay Kumar
AU  - Mishra AK
AD  - Department of Cardiovascular Medicine, St. Vincent Hospital, UMass Chan Medical 
      School, Worcester, Massachusetts.
FAU - Krishnan, Anand M
AU  - Krishnan AM
AD  - Department of Cardiovascular Medicine, Larner College of Medicine at the 
      University of Vermont, Burlington, Vermont, USA.
FAU - Roumia, Mazen
AU  - Roumia M
AD  - Department of Cardiovascular Medicine, St. Vincent Hospital, UMass Chan Medical 
      School, Worcester, Massachusetts.
LA  - eng
PT  - Journal Article
DEP - 20221223
PL  - England
TA  - Coron Artery Dis
JT  - Coronary artery disease
JID - 9011445
SB  - IM
MH  - Adult
MH  - Humans
MH  - Aged
MH  - United States/epidemiology
MH  - Middle Aged
MH  - *ST Elevation Myocardial Infarction/diagnosis/therapy
MH  - Retrospective Studies
MH  - *Percutaneous Coronary Intervention
MH  - Time Factors
MH  - Medicare
MH  - Hospitalization
MH  - Length of Stay
MH  - Hospital Mortality
MH  - Patient Admission
EDAT- 2023/02/01 06:00
MHDA- 2023/02/03 06:00
CRDT- 2023/01/31 15:13
PHST- 2023/01/31 15:13 [entrez]
PHST- 2023/02/01 06:00 [pubmed]
PHST- 2023/02/03 06:00 [medline]
AID - 00019501-202303000-00005 [pii]
AID - 10.1097/MCA.0000000000001211 [doi]
PST - ppublish
SO  - Coron Artery Dis. 2023 Mar 1;34(2):119-126. doi: 10.1097/MCA.0000000000001211. 
      Epub 2022 Dec 23.