ST elevation myocardial infarction – national trend analysis with mortality differences in outcomes based on day of hospitalization

Abstract

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.

Coronary microvascular dysfunction and myocardial area at risk assessed by cadmium zinc telluride single photon emission computed tomography after primary percutaneous coronary intervention in acute myocardial infarction patients

“…AMI is a common life-threatening and serious cardiovascular disease ( 13 , 14 ) for which primary PCI is currently the preferred treatment option ( 1 , 2 , 14 ). In recent years, the aim has been shortening the door-to-balloon time to open the IRA as early as possible for achieving myocardial horizontal reperfusion, but this is hindered by CMD ( 1 , 2 ).…”

Cardiovascular complications following medical termination of pregnancy: An updated review

“…These patients were young and lacked baseline echocardiography or electrocardiography. All the reports of SCAD and TTC consistently did not report cardiac catheterization results[ 80 ]. Reports did not mention functional status at discharge, recurrence, and long-term follow-up details[ 81 - 84 ].…”

The impact of the site of myocardial infarction on in-hospital outcomes for patients with STEMI

“…Depending on the European country, there are between 44 and 142 cases of STEMI per 100 000 people [1]. An evaluation of the 2016 National Inpatient Sample in the USA reported 163 715 patients with STEMI [2]. In-hospital mortality rates in STEMI are estimated to be 5–6% in the USA [3] and between 3–10% in Europe [4].…”