Kim Hyun-Jin, Kim Kwang-Il, Cho Young-Seok, Kang Jeehoon, Park Jin Joo, Oh Il-Young, Yoon Chang-Hwan, Suh Jung-Won, Youn Tae-Jin, Chae In-Ho, Choi Dong-Ju
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
J Korean Med Sci. 2015 Apr;30(4):414-25. doi: 10.3346/jkms.2015.30.4.414. Epub 2015 Mar 19.
We investigated the effects of weekend admission on adverse cardiac events in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Patients with NSTE-ACS treated with percutaneous coronary intervention (PCI) were divided into a "weekend group" and a "weekday group" according to the emergency room arrival time. The primary outcome was 30-day major adverse cardiac events (MACE) including cardiac death, recurrent myocardial infarction, repeat revascularization, and urgent PCI. Of 577 patients, 168 patients were allocated to the weekend and 409 patients to the weekday group. The incidence of 30-day MACE was significantly higher in the weekend group (Crude: 15.5% vs. 7.3%, P = 0.005; propensity score matched: 12.8% vs. 4.8%, P = 0.041). After adjustment for all the possible confounding factors, in Cox proportional hazard regression analysis, weekend admission was associated with a 2.1-fold increased hazard for MACE (HR, 2.13; 95% CI, 1.26-3.60, P = 0.005). These findings indicate that weekend admission of patients with NSTE-ACS is associated with an increase in 30-day adverse cardiac event.
我们研究了非ST段抬高型急性冠状动脉综合征（NSTE-ACS）患者周末入院对不良心脏事件的影响。接受经皮冠状动脉介入治疗（PCI）的NSTE-ACS患者根据急诊室到达时间分为“周末组”和“工作日组”。主要结局是30天主要不良心脏事件（MACE），包括心源性死亡、再发心肌梗死、再次血运重建和紧急PCI。在577例患者中，168例患者被分配到周末组，409例患者被分配到工作日组。周末组30天MACE的发生率显著更高（粗率：15.5%对7.3%，P = 0.005；倾向评分匹配：12.8%对4.8%，P = 0.041）。在对所有可能的混杂因素进行调整后，在Cox比例风险回归分析中，周末入院与MACE风险增加2.1倍相关（HR，2.13；95%CI，1.26 - 3.60，P = 0.005）。这些发现表明，NSTE-ACS患者周末入院与30天不良心脏事件增加相关。
