Never On Sunday

Photo by Bruce Jancin

From the annual scientific session of the American College of Cardiology, Atlanta

If you’re going to have a heart attack, it remains an excellent idea to arrange it for a weekday.

The “weekend effect”–worse outcomes for myocardial infarction patients admitted on Saturday or Sunday–remains operative across the U.S. despite numerous advances in acute cardiac care in recent years, according to a large national study.

The problem, according to Dr. Abhishek Deshmukh, appears to be that fewer of these treatment advances are brought to bear urgently on weekends because of diminished staffing and, in some hospitals, restricted cardiac catheterization lab hours.

He analyzed more than 287,000 MIs included in the 2007 National Inpatient Sample database and found the in-hospital mortality rate for patients admitted on weekends was 7.6% as compared to 6.4% for weekday admissions. After adjustment for hospital characteristics and disease severity, MI patients admitted on weekends had a 23% greater risk of in-hospital death. They also had greater average lengths of stay, got fewer revascularization procedures, and waited almost half-a-day longer for them.

Nevertheless, if chest pain arises on a weekend it remains critical to seek immediate medical care. Waiting it out until Monday is a very bad idea, stressed Dr. Deshmukh, an internal medicine resident at the Medical College of Wisconsin, Milwaukee.

—Bruce Jancin

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Filed under Cardiovascular Medicine, Emergency Medicine, Family Medicine, IMNG, Primary care

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