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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2017 ; 12
(4
): e0175485
Nephropedia Template TP
gab.com Text
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English Wikipedia
Factors attributed to the higher in-hospital mortality of ST elevation myocardial
infarction patients admitted during off-hour in comparison with those during
regular hour
#MMPMID28388683
Li M
; Li S
; Du X
; Wu T
; Li X
; Ma C
; Huo Y
; Hu D
; Gao R
; Wu Y
PLoS One
2017[]; 12
(4
): e0175485
PMID28388683
show ga
BACKGROUND: In-hospital mortality of patients with ST elevation myocardial
infarction (STEMI) admitted during off-hour was reported higher than those
admitted during regular hour, but which factors cause the difference remains
largely unknown though the difference in medical resources was often accused.
METHODS AND RESULTS: This registry-based study recruited 7456 STEMI patients
prospectively from 99 level two hospitals across China. Generalized linear mixed
models were applied to quantify the risk of in-hospital death attributed to
admission time and the explainers of its change, accounting for the clustering of
patients within hospitals. There were 45.2% patients admitted during regular hour
and 54.8% during off-hour. In-hospital mortality was 7.0% for patients admitted
during regular hour and 8.3% for those during off-hour (p<0.05). Generalized
linear mixed models adjusting for age, gender and education showed that patients'
disease severity at admission and medical treatments received after admission
could explain the risk difference attributed to admission time by 55% and 20%,
respectively. After all factors accounted, the residual relative risk difference
left only 6% (adjusted OR = 0.94) and became no longer significant. CONCLUSIONS:
The regular-and-off-hour mortality difference exists among STEMI patients in
Chinese level two hospitals, which could be attributed primarily to disease
severity at admission and secondly to the poorer medical treatments. These
results call for public attention to the more severity of STEMI patients admitted
during off-hour in addition to improving medical resources for STEMI at off-hour.