Press Releases: Colorado
August 16, 2005
Time of day and day of week affects treatment times and survival of heart attack patients
Kaiser Permanente research published in Journal of American Medical Association (JAMA)
DENVER – When every second counts for the life of a heart attack patient, new research suggests patients receive more timely treatment and have a better chance of surviving if they arrive at a hospital during what many people consider "normal office hours," than if they arrive during "off- hours" or on weekends. The article is published in this week's issue of the Journal of the American Medical Association. The research, led by David Magid, MD, emergency physician and director of research of Kaiser Permanente Colorado's Institute for Health Research, found that most heart attack patients arrive at the emergency department during off-hours and weekends and these patients experience significantly longer wait times for treatment with balloon angioplasty or PCI.
The study found that more than half all of heart attack patients arrive at emergency departments outside of "normal office hours." Patients arriving during "off-hours" or on weekends waited longer for treatment. The study also found more deaths during off-hours and weekends than during normal weekday office hours.
Specifically:
Patients treated with PCI or balloon angioplasty during "off-hours" or on weekends experienced a 21 minute longer wait time than patients treated during normal weekday office hours.
Overall, patients arriving during "off-hours" or on weekends had a seven percent higher relative death rate than patients arriving during normal weekday office hours
"Ideally patients with an emergency should receive the same quality of care no matter what time of day or day of week they arrive at the hospital, but for heart attack patients this is not currently happening," said David Magid, emergency physician and lead author on this study. "Hospitals that treat heart attack with balloon angioplasty during "off-hours" and on weekends should perform it in a timely fashion."
The study offers hospitals several considerations to improve their timeliness of treatment when balloon angioplasty is required. It should also be noted that patients who were treated with clot-dissolving drugs also experienced longer treatment times during off-hours and weekends compared to those treated during normal workday office hours, though the differences was modest.
This study is the first to show that delays for balloon angioplasty during "off-hours" or weekends were common across all types of hospitals. It also is the first study to document higher death rates for heart attack patients arriving at a hospital during off-hours and weekends and also show that this higher death rate was partly due to longer off-hours and weekend treatment times.
The study is one of more than 100 research projects conducted by the Kaiser Permanente Colorado Clinical Research Unit. The CRU develops, conducts and translates high-quality research into practice and works to promote evidence-based practices and service-oriented, cost-effective medical care. Investigators partner with prominent research institutions throughout the country including the U. S. Centers for Disease Control and Prevention, and the National Institutes of Health.
About Kaiser Permanente Colorado
The Colorado Permanente Medical Group has an exclusive contract with Kaiser Foundation Health Plan of Colorado to form Kaiser Permanente Colorado, the state's largest private, non-profit health care provider in the state. CPMG is Colorado's largest medical group practice within a health care organization, and employs 800 regular status physicians representing all medical specialties and major sub-specialties. More than 483,000 members in the Denver/Boulder and Colorado Springs areas have access to Kaiser Permanente care through an expanded suite of health care products. Kaiser Permanente physicians and care teams focus on prevention as well as managing disease, all in an effort to help patients live well and thrive. Visit us online at kp.org or get the latest in health news at our News Center.