Anyone who's had the unfortunate experience of having to go to an emergency room knows that certain times, such as holidays and weekends, aren't the best opportunity to be treated in quick fashion.
Now comes new research that reveals time of arrival at an emergency room can impact treatment and survival when it comes to heart attacks.
A new study says heart attack patients who arrive at a hospital on weekend nights, weekends and holidays have a 13 percent increased risk of dying compared to those who are treated during typical business hours.
"Slower door-to-balloon times for people who arrived at the hospital during off hours is likely due to staffing. In the middle of the night, the hospital catheterization lab where angioplasty and other artery-opening procedures are performed is closed," said Jorge Saucedo, M.D., lead author of the study and chief of cardiology and co-director of the Cardiovascular Institute at Northshore University Health System in Evanston, Ill, in a release on the study.
"When a heart attack patient comes to the emergency department at 1 a.m., the emergency staff activate the pagers. Doctors need to drive to the hospital, get things set up in the cath lab, and it takes time."
During business hours those patients needing angioplasty got it 16 minutes faster, and researchers also recorder lower in-hospitals death and improved door-to-needle times.
Time of day impact was not associated with imaging tests, intravenous clot busting meds or aspirin administration.
The study was published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.
According to the release, more than 250,000 people annually experience an ST elevation myocardial infarction (STEMI), the most severe form of heart attack due to a complete blockage of blood to the heart. Restoring blood flow is critical to survival and that's either done by surgery or administering intravenous clot-busting medication.
"The fact that treatments were similar in both groups and that only door-to-balloon time lagged slightly is a credit to continually raising awareness and educating providers about the Mission: Lifeline guidelines," said Saucedo. "Over the past decade, these cardiac emergency protocols carried out by multiple institutions across the country have made a huge impact in saving lives.
In the study the team compared care for 27,270 STEMI patients who arrived off hours and 15,972 STEMI patients who arrived during regular business hours between January 2007 and September 2010 at 447 U.S. hospitals.
"Patients who arrived at the emergency room during regular workday hours had an average door-to-balloon time of 56 minutes compared with 72 minutes for patients who arrived during evenings, weekends and holidays," states the release.
The American Heart Association's guidelines for the treatment of STEMI patients recommends angioplasty in 90 minutes or less. The release states the study revealed almost 88 percent of patients who arrived during regular weekday hours were treated with angioplasty within the association's recommended 90 minute goal versus 79 percent for those who arrived during off hours.
Saucedo said patients should call an ambulance as soon as any symptoms of a heart attack appear. They include excess sweating, weakness, tightness of chest and lightheadedness. The big reason is that treatment can begin in the ambulance and paramedics can alert the hospital ER staff of necessary procedures.
