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Impact of time of admission on short- and long-term mortality in the Vienna STEMI registry.

Abstract：

BACKGROUND:Several studies have shown contradictive findings regarding mortality and hospital admission time in patients presenting with ST-elevation myocardial infarction (STEMI). The aim of this study was to assess the impact of "on-" or "off-hour" admission on short- and long-term all-cause mortality of patients in the advanced Vienna STEMI network between 2003 and 2009. METHODS AND RESULTS:In total, 2829 patients were included into this analysis. Patients were stratified according to admission time into "on-hour" admission (07:30 until 15:00h on weekdays) and "off-hour" admission (15:00-7:30h on weekdays and 24h on weekends). As endpoint of interest, all-cause mortality was investigated after 30days and 3years of follow-up, the latter for all patients and as Landmark analysis for survivors of the index event. Mean age was 60.5±13.3years, 2048 (72.4%) patients were male and 1260 (44.5%) patients presented with anterior wall infarction. 683 (24.1%) patients were admitted "on-hours", 2146 (75.9%) patients were admitted "off-hours". All-cause death occurred in 176 (6.2%) patients after a follow-up of 30days and in 337 (11.9%) patients after 3years. For short- and long-term all-cause mortality no significant differences could be detected between "on-" and "off-hour" admission in univariate and multivariate Cox proportional hazard analyses as well as for propensity score adjusted outcome analysis. CONCLUSION:In the Vienna STEMI network, "on-" or "off-hour" admission had no impact on short- and long-term mortality for all-comers presenting with acute STEMI. Our findings confirm the imperative need for well-structured STEMI networks of care, as previous data repeatedly demonstrated increased adverse cardiovascular outcome for "off-hour" admission.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Tscharre M,Jäger B,Farhan S,Christ G,Schreiber W,Weidinger F,Stefenelli T,Delle-Karth G,Kaff A,Maurer G,Huber K,Vienna STEMI Registry Group.

doi

10.1016/j.ijcard.2017.03.029

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

1-6

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(16)33766-4

journal_volume

244

pub_type

杂志文章,多中心研究

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Impact of time of admission on short- and long-term mortality in the Vienna STEMI registry.