The Effect of Admission at Weekends on Clinical Outcomes in Patients with Non-ST-segment Elevation Acute Coronary Syndrome and Its Contributing Factors.
10.3346/jkms.2015.30.4.414
- Author:
Hyun Jin KIM
1
;
Kwang Il KIM
;
Young Seok CHO
;
Jeehoon KANG
;
Jin Joo PARK
;
Il Young OH
;
Chang Hwan YOON
;
Jung Won SUH
;
Tae Jin YOUN
;
In Ho CHAE
;
Dong Ju CHOI
Author Information
1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. flammeus1@gmail.com
- Publication Type:Original Article
- Keywords:
Coronary Artery Disease;
Acute Coronary Syndrome;
Percutaneous Coronary Intervention
- MeSH:
Acute Coronary Syndrome/*complications/mortality/therapy;
Adult;
Aged;
*Death;
Female;
Humans;
Male;
Middle Aged;
Myocardial Infarction/*epidemiology;
Patient Admission;
Percutaneous Coronary Intervention/*statistics & numerical data;
Propensity Score;
Proportional Hazards Models;
Time Factors;
Treatment Outcome
- From:Journal of Korean Medical Science
2015;30(4):414-425
- CountryRepublic of Korea
- Language:English
-
Abstract:
We investigated the effects of weekend admission on adverse cardiac events in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Patients with NSTEACS treated with percutaneous coronary intervention (PCI) were divided into a "weekend group" and a "weekday group" according to the emergency room arrival time. The primary outcome was 30-day major adverse cardiac events (MACE) including cardiac death, recurrent myocardial infarction, repeat revascularization, and urgent PCI. Of 577 patients, 168 patients were allocated to the weekend and 409 patients to the weekday group. The incidence of 30-day MACE was significantly higher in the weekend group (Crude: 15.5% vs. 7.3%, P = 0.005; propensity score matched: 12.8% vs. 4.8%, P = 0.041). After adjustment for all the possible confounding factors, in Cox proportional hazard regression analysis, weekend admission was associated with a 2.1-fold increased hazard for MACE (HR, 2.13; 95% CI, 1.26-3.60, P = 0.005). These findings indicate that weekend admission of patients with NSTE-ACS is associated with an increase in 30-day adverse cardiac event.
