Procedural Characteristics and Outcomes of Patients Undergoing Percutaneous Coronary Intervention During Normal Work Hours Versus Non-work Hours.

MedStar author(s):
Citation: American Journal of Cardiology. 135:32-39, 2020 11 15.PMID: 32866443Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *After-Hours Care | *Angina, Stable/su [Surgery] | *Angina, Unstable/su [Surgery] | *Myocardial Infarction/su [Surgery] | *Percutaneous Coronary Intervention | After-Hours Care/sn [Statistics & Numerical Data] | Aged | Cohort Studies | Female | Humans | Male | Middle Aged | Percutaneous Coronary Intervention/mt [Methods] | Retrospective Studies | Treatment OutcomeYear: 2020Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0002-9149
Name of journal: The American journal of cardiologyAbstract: Percutaneous coronary intervention (PCI) performed during non-work hours is believed to have inferior outcomes because of operator fatigue, differences in baseline patient characteristics, and fewer on-call catheterization laboratory staff. We aimed to analyze a cohort of patients who underwent PCI (all comers) at our tertiary-care center between January 1, 2006, and December 31, 2018, and compare procedural and in-hospital outcomes between 2 groups defined by whether PCI was performed during normal work hours (7:00 A.M. to 7:00 PM) versus non-work hours (7:01 P.M. to 6:59 A.M. weekdays; all hours weekends and holidays). Finally, we examined temporal changes throughout the 24-hour weekday. Primary outcomes were unadjusted in-hospital adverse outcomes (composite death, recurrent myocardial infarction, emergent coronary artery bypass grafting, and target lesion revascularization). We identified 21,848 patients who underwent PCI at our institution. The proportions of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) were higher during non-work hours. Overall, unadjusted in-hospital adverse outcomes were higher during non-work hours than during normal work hours (8.80% vs 2.00%; p <0.001). These findings were consistent based on the patient's clinical presentation (STEMI, NSTEMI, unstable angina, and stable angina). Despite confounding variables in the patients' presentations preventing definite causal attribution, our analysis demonstrates that in-hospital adverse outcomes were higher for those patients who underwent PCI (all comers) who had their procedures during non-work hours than during normal work hours. Copyright (c) 2020 Elsevier Inc. All rights reserved.All authors: Ben-Dor I, Bernardo N, Case BC, Chen Y, Forrestal BJ, Hashim H, Musallam A, Rogers T, Satler LF, Torguson R, Waksman R, Weintraub WS, Wermers JP, Yerasi CT, Zhang COriginally published: American Journal of Cardiology. 2020 Aug 28Fiscal year: FY2021Digital Object Identifier: Date added to catalog: 2020-10-06
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 32866443 Available 32866443

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

Percutaneous coronary intervention (PCI) performed during non-work hours is believed to have inferior outcomes because of operator fatigue, differences in baseline patient characteristics, and fewer on-call catheterization laboratory staff. We aimed to analyze a cohort of patients who underwent PCI (all comers) at our tertiary-care center between January 1, 2006, and December 31, 2018, and compare procedural and in-hospital outcomes between 2 groups defined by whether PCI was performed during normal work hours (7:00 A.M. to 7:00 PM) versus non-work hours (7:01 P.M. to 6:59 A.M. weekdays; all hours weekends and holidays). Finally, we examined temporal changes throughout the 24-hour weekday. Primary outcomes were unadjusted in-hospital adverse outcomes (composite death, recurrent myocardial infarction, emergent coronary artery bypass grafting, and target lesion revascularization). We identified 21,848 patients who underwent PCI at our institution. The proportions of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) were higher during non-work hours. Overall, unadjusted in-hospital adverse outcomes were higher during non-work hours than during normal work hours (8.80% vs 2.00%; p <0.001). These findings were consistent based on the patient's clinical presentation (STEMI, NSTEMI, unstable angina, and stable angina). Despite confounding variables in the patients' presentations preventing definite causal attribution, our analysis demonstrates that in-hospital adverse outcomes were higher for those patients who underwent PCI (all comers) who had their procedures during non-work hours than during normal work hours. Copyright (c) 2020 Elsevier Inc. All rights reserved.

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