March 14, 2007
Contact: Patricia Hansen
Phone: (732) 235-6307
UMDNJ Study on Heart Attack Outcomes Shows Day
of Hospital Admission a Factor in Mortality Rate
NEW BRUNSWICK — Researchers at University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School report that patients with myocardial infarction (heart attack) who were admitted to a hospital on a weekend experienced higher mortality rates than patients who were admitted for the same diagnosis on a weekday. The study, which appeared in the March 15th issue of the New England Journal of Medicine, concludes that the higher mortality rates may be due to the lower use of invasive cardiac procedures on the weekends. Invasive cardiac procedures included cardiac catheterization, PCI (percutaneous coronary intervention, such as balloon angioplasty or stent placement) or coronary artery bypass graft surgery.
“The study included 231,164 patients admitted to New Jersey hospitals between 1987 and 2002 with acute myocardial infarction as the primary reason for admission,” explains William J. Kostis, PhD, lead author of the study, and a fourth year medical student and researcher at Robert Wood Johnson Medical School.
The researchers report that patients with a first myocardial infarction admitted on a weekend had a 0.9% increase in mortality, or about nine to 10 additional deaths per 1,000 heart attack admissions, and could account for several thousand deaths each year in the U.S.
The data used in the study was from the Myocardial Infarction Data Acquisition System (an anonymized statewide database), which contains sociodemographic, and clinical data on patients with the diagnosis of acute myocardial infarction hospitalized in all nonfederal acute care hospitals across the entire State of New Jersey. The database also includes records of all invasive cardiac procedures performed throughout the state and whether the patients had coexisting conditions such as diabetes, hypertension, chronic obstructive pulmonary disease, chronic liver disease, chronic renal disease, anemia, cerebrovascular disease, or cancer. The aggregated data was then matched with the New Jersey State mortality files and compared for outcomes.
“Overall, our study suggests that a hospital workweek of Monday through Friday is not optimal for the care of patients with acute myocardial infarction,” adds Dr. Kostis. “More appropriate hospital staffing or regionalization of care of patients with heart attacks may improve outcomes for weekend admissions.”
Media interviews with Dr. William Kostis may be arranged by calling: 732-235-6307 or 732-235-7685.
Additional investigators include:
Kitaw Demissie, MD, PhD, UMDNJ-School of Public Health
Stephen W. Marcella, MD, MPH, UMDNJ-School of Public Health
Yu-Hsuan Shao, MHS, UMDNJ-Robert Wood Johnson Medical School
Alan C. Wilson, PhD, UMDNJ-Robert Wood Johnson Medical School
Abel E. Moreyra, MD, UMDNJ-Robert Wood Johnson Medical School
UMDNJ is the nation’s largest free-standing public health sciences university with more than 5,500 students attending the state's three medical schools, its only dental school, a graduate school of biomedical sciences, a school of health related professions, a school of nursing and a school of public health on five campuses. Annually, there are more than two million patient visits at UMDNJ facilities and faculty practices at campuses in Newark, New Brunswick/Piscataway, Scotch Plains, Camden and Stratford. UMDNJ operates University Hospital, a Level I Trauma Center in Newark, and University Behavioral HealthCare, a statewide mental health and addiction services network.