Procedural Characteristics and Outcomes of Patients Undergoing Percutaneous Coronary Intervention During Normal Work Hours Versus Non-work Hours. - 2020

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.


English

0002-9149

10.1016/j.amjcard.2020.08.028 [doi] S0002-9149(20)30885-7 [pii]


*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 Outcome


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Journal Article