More Heart Attack Deaths On Weekends

Fewer Aggressive Treatments Given Than On Weekdays, Study Shows

(WebMD)  You may have a better chance of surviving a heart attack on a weekday.

Heart attack patients admitted to hospitals on weekends appear to have a higher death rate than those admitted during the week, new research shows.

After reviewing hospital admissions data for first-time heart attacks in New Jersey over a 15-year period, researchers concluded that the difference in mortality for weekend vs. weekday admissions was roughly 1 percent.

That means that for every 100 people treated for first-time heart attacks on the weekends, one person will die unnecessarily, the study's author, William J. Kostis, Ph.D., tells WebMD. The study appears in The New England Journal of Medicine.

Last week, Canadian researchers reported similar findings in stroke patients. They concluded that stroke victims were 13 percent more likely to die when they were hospitalized on weekends than on weekdays.

Though the suggestion from both studies is that many hospitals may not offer their highest level of critical care during the weekends, nobody is suggesting that patients delay treatment even for a minute.

"If a person is having symptoms that suggest a heart attack or stroke, it is absolutely critical that they get to a hospital as quickly as possible, and that usually involves calling 911," Kostis says.

The best way to stop a heart attack in its tracks is to open blocked arteries as soon as possible.

"No matter what day it is, seeking care is infinitely better than staying home with a potentially fatal illness," American Heart Association spokesman David A. Meyerson, MD, tells WebMD.

Less Aggressive Treatment

In the newly reported study, published in the March 15 issue of The New England Journal of Medicine, Kostis and colleagues from the Robert Wood Johnson Medical School examined hospital admissions data from all New Jersey hospitals between 1987 and 2002.

During that time, 231,164 patients were admitted to hospitals for first-time heart attacks.

No major differences were seen in the patients' demographic characteristics, overall health, or heart attack site.

But patients admitted on the weekends were one-third less likely to undergo artery-opening procedures such as balloon angioplasty by the second hospital day.

They were also less likely to receive other interventions, including heart bypass surgery.

The researchers suggest that the increase in deaths during weekend admissions is probably due to the failure to offer these treatments.

"Everyone who is familiar with hospitals knows that things don't always work exactly the same on weekends as on weekdays," Kostis says. "But now we have a very large, population-based study showing an actual increase in mortality. That will be hard to ignore."

Awareness Greater Today

Meyerson agrees that the findings should not be ignored, but he says the study may paint too grim a picture of the current reality in hospital ERs.

That is because the most recent hospital admissions included in the study were from 2002. He says awareness of the importance of early, aggressive treatment for heart attack and stroke is much greater now than it was five
years ago.

"We know that we need to get these people from the ER to the catheterization
laboratory in as little time as possible," he says.

But he adds that the findings should serve as a wake-up call to hospitals,
especially those that are not offering their highest level of care on the
weekends.

Meyerson is director of cardiology consultative services at Johns Hopkins
and Johns Hopkins Bayview Medical Center in Baltimore.

"A hospital which promotes itself as a center for excellence in cardiac or
stroke care must provide the same levels of excellence 24/7," he says. "The
quality of this care must be seamless between weekdays and weekends."