Heart Attack Patients Wait Longer for Treatment on Nights, Weekends, Study Finds
Heart attack patients who go to the hospital after business hours or on the weekend have longer wait times to receive emergency angioplasty or clot-busting drugs than patients who came in during regular hours, according to a study published Wednesday in the Journal of the American Medical Association, the AP/Lexington Herald-Leader reports (Johnson, AP/Lexington Herald-Leader, 8/16).
For the study, researchers analyzed data from 100,000 heart attacks recorded in the National Registry of Myocardial Infarction from 1999 to 2004. All of the patients studied had artery blockages that doctors attempted to treat using either clot-busting drugs or emergency angioplasty (Sternberg, USA Today, 8/17). Two-thirds of the patients in the study arrived at hospitals during the night or on weekends (AP/Lexington Herald-Leader, 8/16).
A total of 68,439 patients were given clot-busting drugs, while 33,647 were treated with balloon angioplasty, which studies have shown to be more effective than clot busters. About 20% of hospitals are equipped to perform emergency angioplasty. According to the study, among patients receiving clot busting drugs, 45% of those who arrived at the hospital during business hours received the medication within the half-hour guideline set by the American Heart Association, while 40% of patients who arrived at night or on weekends were treated within 30 minutes (USA Today, 8/17).
For patients who received emergency angioplasty, 47% of regular-hours patients were treated within the AHA's guideline of 90 minutes, while 26% of after-hours patients received angioplasty during that timeframe (AP/Lexington Herald-Leader, 8/16). On average, clot-busting drugs were given to patients within 33 minutes of arriving at a hospital during regular hours and within 44 minutes after hours. Wait times for angioplasty patients increased from 95 minutes during regular hours to 116 minutes after hours (USA Today, 8/17).
Delays in treatment can increase the risk of death by 7% (AP/Lexington Herald-Leader, 8/17).
Lead author Harlan Krumholz of Yale University said, "This doesn't mean we're missing people once in a while. It means that the majority of people are not being treated within the time recommended for good care."
Lawton Cooper of the National Heart, Lung and Blood Institute, which sponsored the study, said, "There's a difference between off hours and regular hours no matter which type of hospital you're talking about" (USA Today, 8/17).
Researchers noted that most hospitals are not able to staff catherization laboratories 24 hours per day and suggested that hospitals find better ways to call in after-hours staff to the labs or cross-train other staffers to help with after-hours angioplasty (AP/Lexington Herald-Leader, 8/16).
An abstract of the study is available online.