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Inpatient MI more likely to be fatal at night

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Patients who have a myocardial infarction while in hospital at night have a significantly lower rate of survival to discharge than those at other times of day, suggests a US study.

Researchers studied a total of 58,593 cases of in-hospital cardiac arrest that occurred during day/evening hours and 28,155 cases occurring during night hours. The rate of survival to discharge was 14.6% for those that occurred at night compared to 19.8% for during the day or evening.

The study authors said: ‘The mechanism for the decreased survival during the night is likely multi-factorial, potentially including biological differences in patients as well as health care staff and hospital staffing and operational factors.

They also found that survival during weekdays was higher than at weekends – 20.6% versus 17.4%.

‘These data suggest the need to focus on night and weekend hospital-wide resuscitation system processes of care that can potentially improve patient safety and survival following cardiac arrest,’ they added.

Journal of the American Medical Association (2008) 299: 785-792

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