Emergency Department Weekend Presentation and Mortality in Patients With Acute Myocardial Infarction.
Pamela B de Cordova1, Mary L Johansen, Miguel E Martinez
1Pamela B. de Cordova, PhD, RN-BC, is Assistant Professor of Nursing, Rutgers, the State University of New Jersey, New Brunswick, and Research Faculty, New Jersey Collaborating Center for Nursing, Newark. Mary L. Johansen, PhD, NE-BC, is Clinical Associate Professor, Rutgers, the State University of New Jersey, New Brunswick, and Associate Director, New Jersey Collaborating Center for Nursing, Newark. Miguel E. Martinez, MA, is Senior Institutional Research Analyst, Emory University, Atlanta, Georgia. Jeannie P. Cimiotti, PhD, RN, FAAN, is Associate Professor and Dorothy M. Smith Endowed Chair Director, Florida Blue Center for Health Care Quality, University of Florida College of Nursing, Gainesville.
Patients presenting with heart attacks on weekends or holidays had a higher risk of death in the emergency department (ED). This study highlights potential disparities in care during non-peak hours.
Area of Science:
- Cardiology
- Emergency Medicine
- Health Services Research
Background:
- Weekend hospital admissions are linked to poorer patient outcomes.
- Patients with acute myocardial infarction (AMI) admitted on weekends face higher mortality rates.
- Limited research exists on weekend AMI presentation and emergency department (ED) mortality.
Purpose of the Study:
- To investigate the association between weekend/holiday presentation and mortality in ED patients with AMI in New Jersey.
- To determine if emergency care during weekends and holidays impacts survival rates for acute myocardial infarction.
Main Methods:
- Retrospective cohort study using New Jersey hospital data (2008-2010).
- Included patients aged 18-90 presenting to the ED with AMI symptoms.
- Propensity score matching with probit regression analyzed weekend/holiday presentation effects on ED mortality.
Main Results:
- Of 1,343 AMI patients, 382 (28%) presented on weekends/holidays.
- Weekend/holiday presentation was significantly associated with increased ED mortality (b = 0.30, 95% CI [0.03, 0.57]).
- Patient age, hospital technology, and nurse staffing also significantly impacted mortality.
Conclusions:
- Weekend/holiday ED presentation for AMI is linked to higher mortality.
- Resource availability may be reduced during weekends/holidays, contributing to poorer outcomes.
- Further research is needed on ED resource variations and healthcare provider factors during weekends.
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