TY - BOOK AU - Ben-Dor, Itsik AU - Bernardo, Nelson L AU - Case, Brian C AU - Chen, Yuefeng AU - Forrestal, Brian J AU - Hashim, Hayder AU - Musallam, Anees AU - Rogers, Toby AU - Satler, Lowell F AU - Torguson, Rebecca AU - Waksman, Ron AU - Weintraub, William S AU - Wermers, Jason P AU - Yerasi, Charan AU - Zhang, Cheng TI - Procedural Characteristics and Outcomes of Patients Undergoing Percutaneous Coronary Intervention During Normal Work Hours Versus Non-work Hours SN - 0002-9149 PY - 2020/// KW - *After-Hours Care KW - *Angina, Stable/su [Surgery] KW - *Angina, Unstable/su [Surgery] KW - *Myocardial Infarction/su [Surgery] KW - *Percutaneous Coronary Intervention KW - After-Hours Care/sn [Statistics & Numerical Data] KW - Aged KW - Cohort Studies KW - Female KW - Humans KW - Male KW - Middle Aged KW - Percutaneous Coronary Intervention/mt [Methods] KW - Retrospective Studies KW - Treatment Outcome KW - MedStar Heart & Vascular Institute KW - Journal Article N1 - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006 N2 - 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 UR - https://dx.doi.org/10.1016/j.amjcard.2020.08.028 UR - https://dx.doi.org/10.1016/j.amjcard.2020.08.028 ER -