Comparison of in-hospital mortality for acute myocardial infarction in Switzerland with admission during routine duty hours versus admission during out of hours (Insight into the AMIS Plus Registry)
Comparison of in-hospital mortality for acute myocardial infarction in Switzerland with admission during routine duty hours versus admission during out of hours (Insight into the AMIS Plus Registry)
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DOI：
10.1016/j.amjcard.2007.09.092
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发表时间：
2008-02-15
影响因子：
2.8
通讯作者：
Erne, Paul
中科院分区：
文献类型：
--
作者：
Berger, Alexandre;Stauffer, Jean-Christophe;Erne, Paul
为了提高长期生存率，急性心肌梗死（AMI）患者应及时进行梗死相关动脉的血运重建;因此，这些患者中有很大一部分会在非工作时间住院。非工作时间AMI管理的临床效果已经受到质疑，结果相互矛盾。本研究的目的是比较在非工作时间和工作时间因急性心肌梗死入院的患者的住院结局。分析了1997年1月1日至2006年3月30日AMIS Plus登记研究中纳入的所有AMI患者。工作时间组包括工作日上午7点至下午7点入院的患者，非工作时间组包括工作日或周末下午7点至上午7点入院的患者。主要心脏事件定义为心血管死亡、再梗死和卒中。研究的主要终点是院内死亡和主要不良心脏事件（MACE）发生率。共有12，480名患者符合入选标准，其中52%在正常工作时间入院，48%在非工作时间入院。在工作日入院的患者包括更多的女性（28.1% vs 26%; p = 0.009），老年患者（65.5 +/- 13 vs 64.1 +/- 13岁; p = 0.0011），目前吸烟者较少（40.1% vs 43.5%; p = 0.0011），
To improve long-term survival, prompt revascularization of the infarct-related artery should be done in patients with acute myocardial infarction (AMI); therefore, a large proportion of these patients would be hospitalized during out of hours. The clinical effects of out-of-hours AMI management were already questioned, with conflicting results. The purpose of this investigation was to compare the in-hospital outcome of patients admitted for AMI during out of hours and working hours. All patients with AMI included in the AMIS Plus Registry from January 1, 1997, to March 30, 2006, were analyzed. The working-hours group included patients admitted from 7 A.M. to 7 P.M. on weekdays, and the out-of-hours group included patients admitted from 7 P.M. to 7 A.M. on weekdays or weekends. Major cardiac events were defined as cardiovascular death, reinfarction, and stroke. The study primary end points were in-hospital death and major adverse cardiac event (MACE) rates. A total of 12,480 patients met the inclusion criteria, with 52% admitted during normal working hours, and 48%, during out of hours. Patients admitted during weekdays included more women (28.1% vs 26%; p = 0.009), older patients (65.5 +/- 13 vs 64.1 +/- 13 years; p = 0.0011), less current smokers (40.1% vs 43.5%; p