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To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in ST-elevation myocardial infarction (STEMI) patients.
All STEMI patients who admitted to emergency department and then underwent primary percutaneous coronary intervention at Peking University People's Hospital from April 2012 to March 2015 were recruited. We examined the differences in clinical characteristics, total ischemic time and in-hospital death between patients admitted during off-hours versus regular hours. Then, multivariable logistic regression were used to estimate the relationship between off-hours admission and clinical outcome.
There were 184 and 105 STEMI patients who admitted to hospital during off-hours and regular hours, respectively. Total ischemic and onset-to-door time were significantly shorter in off-hours admission patients than regular hours admission patients. However, door-to-balloon (DTB) time, the rate of achieving DTB time≤90min, and in-hospital death were comparable between off-hours and regular hours patients. Multivariate logistic regression showed that only age and creatinine, but not off-hours admission, were independently associated with increased in-hospital death.
Despite shorter total ischemic and onset-to-door time, STEMI patients admitted during off-hours had similar DTB time, the rate of achieving DTB time≤90min, and in-hospital death. Moreover, off-hours admission patients may not be at risk for increased in-hospital mortality.