Weekend Effects Of Acute ST-segment Elevation Myocardial Infarction

Objective:Researching the baseline characteristics,admission-related examinations,treatment and patients in-hospital outcomes of STEMI patients to explore whether patients admitted at different times are different with mortality,and to find some improvement measuresMethods:2272 STEMI patients who were admitted to the Bethune First Hospital of Jilin University from November 2017 to October 2018.There are 2188 patients who met the exclusion criteria.They were divided into 2 groups according to admission time,admission on the working day(1603 cases),and admission on weekends(669 cases).We can comparative examination of in-hospital mortality between groups according to comparing admission baseline data and to use binary logistic regression model.Results:1.Patients admitted during weekend and holidays had a higher in-hospital mortality rate than those admitted during on weekdays(In-hospital mortality: weekends and holidays: 8.7%;weekdays: 5.4% P = 0.004,the difference was statistically significant)?In terms of age,gender,previous heart disease history,and coronary artery opening,there were no significant differences between the two groups P <0.05.2.Patients admitted to the hospital on weekends and holidays have worse cardiac function(KillipI level on weekends and holidays: 55.8%,on weekdays 76.9%,KillipII level on weekends and holidays: 35.4%,on weekdays 14.9%),and higher peak troponin I(troponin I on weekends and holidays: 30.0(10.0,80.0),on weekdays:18.9(5.0,75.3)and more comorbidities(History of hypertension on weekends and holidays: 53.7%,on weekdays 37.2%;history of diabetes on weekends and holidays : 35.9%,on weekdays 19.0%,and worse living habits(smoking history on weekends and holidays: 64.4%,on weekdays 45.8%)the differences in the above factors between the two groups were statistically significant.3.The result of coronary angiography of STEMI patients who undergoing emergency Percutaneous coronary intervention(PCI)showed that in terms of the degree of vascular disease,ischemic time,DTB time,and 90-minute compliance rate of DTB time,there was no significant difference between the two groups at weekends and working days.4.Multivariate Logistic regression analysis of in-hospital mortality showed that admission on weekends and holidays,unopened blood vessels,and higher KILLIP classification were independent risk factors for in-hospital death.5.In age group,we found that the mortality rate basically increases with age.The risk of death on weekend admissions generally decreases with age.In the gender group,mortality among men was lower than for women,the risk of dying in hospital during weekend admissions among men was slightly superior than for women.Conclusion:1.Weekend effect can be observed in STEMI patients in our hospital(patients admitted on weekends and holidays have high mortality rates).Admission on weekends and holidays is an independent risk factor for hospital mortality.2.Patients admitted on weekends and holidays have more comorbidities and are more severe.3.There are no difference in the diagnosis and treatment process and nursing procedures of STEMI patients who are admitted to the emergency department for direct PCI on weekends and working days.The diagnosis and treatment of STEMI patients admitted to outpatient or elective PCI need to be strengthened.