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{
    "pk": 8562,
    "title": "Reassessing After-Hour Arrival Patterns and Outcomes in  ST-Elevation Myocardial Infarction",
    "subtitle": null,
    "abstract": "Introduction: \nDifferences in after-hours capability or performance of ST-elevation myocardial infarction (STEMI) centers has the potential to impact outcomes of patients presenting outside of regular hours.\nMethods: \nUsing a prospective observational study, we analyzed all 1,247 non-transfer STEMI patients treated in 15 percutaneous coronary intervention (PCI) facilities in Dallas, Texas, during a 24-month period (2010-2012). Controlling for confounding factors through a variety of statistical techniques, we explored differences in door-to-balloon (D2B) and in-hospital mortality for those presenting on weekends vs. weekdays and business vs. after hours.\nResults: \nPatients who arrived at the hospital on weekends had larger D2B times compared to weekdays (75 vs. 65 minutes; KW=48.9; p<0.001). Patients who arrived after-hours had median D2B times >16 minutes longer than those who arrived during business hours and a higher likelihood of mortality (OR 2.23, CI [1.15-4.32], p<0.05).\nConclusion: \nWeekends and after-hour PCI coverage is still associated with adverse D2B outcomes and in-hospital mortality, even in major urban settings. Disparities remain in after-hour STEMI treatment. [West J Emerg Med. 2015;16(3):388–394.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "STEMI, Door to Balloon, Outcomes"
        }
    ],
    "section": "Health Outcomes",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/6582f6nx",
    "frozenauthors": [
        {
            "first_name": "James",
            "middle_name": "",
            "last_name": "Langabeer",
            "name_suffix": "",
            "institution": "University of Texas Health Science Center, Houston, Texas",
            "department": "None"
        },
        {
            "first_name": "Diaa",
            "middle_name": "",
            "last_name": "Alqusairi",
            "name_suffix": "",
            "institution": "University of Texas Health Science Center, Division of Management, Policy, and Community Health, Houston, Texas",
            "department": "None"
        },
        {
            "first_name": "Jami",
            "middle_name": "L.",
            "last_name": "DelliFraine",
            "name_suffix": "",
            "institution": "Medical University of South Carolina, Department of Healthcare Leadership and Management, Charleston, South Carolina",
            "department": "None"
        },
        {
            "first_name": "Ray",
            "middle_name": "",
            "last_name": "Fowler",
            "name_suffix": "",
            "institution": "UT Southwestern Medical Center, Department of Emergency Medicine, Dallas, Texas",
            "department": "None"
        },
        {
            "first_name": "Richard",
            "middle_name": "",
            "last_name": "King",
            "name_suffix": "",
            "institution": "UT Southwestern Medical Center, Department of Health Care Sciences, Dallas, Texas",
            "department": "None"
        },
        {
            "first_name": "Wendy",
            "middle_name": "",
            "last_name": "Segrest",
            "name_suffix": "",
            "institution": "American Heart Association, United States",
            "department": "None"
        },
        {
            "first_name": "Timothy",
            "middle_name": "",
            "last_name": "Henry",
            "name_suffix": "",
            "institution": "Cedars-Sinai Heart Institute, United States",
            "department": "None"
        }
    ],
    "date_submitted": "2014-10-07T15:56:25Z",
    "date_accepted": "2014-10-07T15:56:25Z",
    "date_published": "2015-04-02T22:22:53Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/8562/galley/4938/download/"
        }
    ]
}