Prognosis and treatment in patients admitted with acute myocardial infarction on weekends and weekdays from 1997 to 2009

Bidragets oversatte titel: Prognose og behandling blandt patienter indlagt med akut myokardieinfarkt på weekender og hverdage fra 1997 til 2009

Kim Wadt Hansen, Anders Hvelplund, Steen Zabell Abildstrøm, Eva Prescott, Mette Madsen, Jan Kyst Madsen, Jan Skov Jensen, Rikke Sørensen, Søren Galatius

29 Citationer (Scopus)

Abstract

BACKGROUND: Less invasive treatment and poorer outcomes have been shown among patients admitted with acute myocardial infarction (AMI) on weekends compared to weekdays. OBJECTIVES: To investigate the 'weekend-effect' on mortality in patients with AMI. METHODS: Using nationwide registers we identified 92,164 patients aged 30-90years who were admitted to a Danish hospital with a first AMI from 1997 to 2009. Patients were stratified according to weekday- or weekend admissions and four time-periods to investigate for temporal changes. All-cause mortality at 2, 7, 30, and 365days was investigated using proportional hazards Cox regression. RESULTS: Mortality rates were higher on weekends within seven days of admission in 1997-99 (absolute difference ranging from 0.8 to 1.1%). Weekend-weekday hazard-ratios were 1.13 (1.03-1.23) at day 2 and 1.10 (1.01-1.18) at day 7. There were no significant differences in 2000-09 and estimates suggested an attenuation of the initial 'weekend-effect'. Overall, the use of coronary angiography (34.9% vs. 72.3%) and percutaneous coronary intervention (6.6% vs. 51.0%) within 30days increased, as did the use of statins (49.9% vs. 80.1%.) and clopidogrel (26.7% vs. 72.7%). The cumulative mortality decreased during the study period from 5.4% to 2.5% at day of admission, from 19.5% to 11.0% at day 30 and from 28.0% to 19.0% at day 365 (all tests for trend p
Bidragets oversatte titelPrognose og behandling blandt patienter indlagt med akut myokardieinfarkt på weekender og hverdage fra 1997 til 2009
OriginalsprogEngelsk
TidsskriftInternational Journal of Cardiology
ISSN0167-5273
DOI
StatusUdgivet - 2012

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