Day of admission and risk of myocardial infarction mortality in a cardiac care unit in Basrah, Iraq

Abstract

Background: Among many factors that may affect the in.hospital mortality among acute myocardial infarction (AMI) patients admitted to the cardiac care unit (CCU), the day and time of admission have been reported to play some role, but such relationship is controversial.
Objective: The objective of the following study is to assess the effect of the day and time of admission on in-hospital mortality of patients with AMI.
Subjects and Methods: Retrospective analysis of data of all patients with AMI who were admitted to the CCU in Al-Sadr Teaching Hospital, Basrah, Iraq during 2010 was conducted.
Results: A total of 419 patients were included in this analysis. The mean age of patients was 62.4 } 11.6 years, 64.9% of them were men. Admission during weekdays was greater than that during weekends (63.2% vs. 36.8%). Admission during off hours was greater than that during regular-hours (59.9% vs. 41.1%). Weekend admissions were more likely
to be presenting with ST elevation myocardial infarction, complications and hypotension. A likewise pattern of baseline characteristics was found among patients admitted at the off-hours time. The overall in-hospital mortality rate was 16.5%. The weekend admission was associated with a higher unadjusted hospital mortality rate than that for weekday admission (23.4% vs. 12.5%, respectively; odds ratio [OR], 2.14; 95% confidence interval [CI], 1.27.3.61; P = 0.004). In multivariate analyzes, no statistically significant difference in mortality was found between weekend and weekday admissions (OR, 0.658; 95% CI,  0.311.1.392). Whereas, off.hours admission was significantly associated with a higher mortality (25.5% vs. 3%; P < 0.001), adjusted OR, 12.178; 95% CI, 3.846.38.442.
Conclusion: Of predictors for the in-hospital outcome of AMI, day of admission had no significant influence on mortality, whereas off-hour admission was associated with an increased risk of AMI in-hospital mortality.

Key words: In-hospital mortality, myocardial infarction, weekend