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Thursday, August 18, 2005A new study finds that heart attack sufferers who go to hospitals on nights and weekends wait longer for an artery-clearing angioplasty than patients during regular hours, increasing their risk of dying. After-hours patients waited an average of one hour and 56 minutes for what is considered the best treatment for heart attacks in most cases, compared with one hour and 35 minutes for patients during regular business hours. Since two-thirds of heart attack patients showed up at hospitals on nights and weekends, the study suggests that hospitals must find better ways to more quickly bring after-hours staff into cardiac catherization labs, where the angioplasties are performed, said study co-author Dr. Harlan Krumholz of Yale University School of Medicine. ...The wait was less for after-hours patients receiving another common heart-attack treatment _ medication for dissolving blood clots. They waited on average only a minute longer than patients who arrived during normal hours. The reason for the delay in angioplasty, is that the patient has to wait for the arrival of the interventional cardiologist and the cath team. But there's no delay in thrombolytic therapy because the emergency room doctor and his staff can administer it. So why not just give everyone thrombolytic therapy? It's a little riskier - there's a chance of bleeding (including into the brain) and there's also a greater failure rate than with angioplasty. At least one study suggests that patients do better with angioplasty even if they have to be transferred elsewhere for it. Even the authors of the current study concede that the thrombolytic therapy patients' mortality was underestimated because more of them had to be transferred elsewhere for further intervention after their thrombolytic therapy. Given that 2/3 of heart attacks present after hours, maybe it would make more sense to have the cath labs fully staffed after hours. Although it wouldn't be too popular with interventional cardiologists. posted by Sydney on 8/18/2005 09:19:00 AM 0 comments 0 Comments: |
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