Evidence-based therapies and mortality in patients hospitalized in December with acute myocardial infarction.
BACKGROUND
Previous studies suggest that patients hospitalized with acute myocardial infarction (MI) in December have poor outcomes, and some studies have hypothesized that the cause may be the infrequent use of evidence-based therapies during the December holiday season.


OBJECTIVE
To compare the care and outcomes of patients with acute MI hospitalized in December and patients hospitalized during other months.


METHODS
Retrospective analysis of data from the Cooperative Cardiovascular Project.


METHODS
Nonfederal, acute care hospitals in the United States.


METHODS
127 959 Medicare beneficiaries hospitalized between January 1994 and February 1996 with confirmed acute MI.


METHODS
Use of aspirin, beta-blockers, and reperfusion therapy (thrombolytic therapy or percutaneous coronary intervention), and 30-day mortality.


RESULTS
When the authors controlled for patient, hospital, and physician characteristics, the use of evidence-based therapies was not significantly lower but 30-day mortality was higher (21.7% vs. 20.1%; adjusted odds ratio, 1.07 [95% CI, 1.02 to 1.12]) among patients hospitalized in December.


CONCLUSIONS
This was a nonrandomized, observational study. Unmeasured characteristics may have contributed to outcome differences.


CONCLUSIONS
Thirty-day mortality rates were higher for Medicare patients hospitalized with acute MI in December than in other months, although the use of evidence-based therapies was not significantly lower.
Meine
Trip J
TJ
Duke University Medical Center, Durham, North Carolina, USA.
Patel
Manesh R
MR
DePuy
Venita
V
Curtis
Lesley H
LH
Rao
Sunil V
SV
Gersh
Bernard J
BJ
Schulman
Kevin A
KA
Jollis
James G
JG
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D006760:Hospitalization; D006801:Humans; D006278:Medicare; D017202:Myocardial Ischemia / Q000401:mortality* / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012621:Seasons; D015912:Thrombolytic Therapy; D014481:United States / Q000453:epidemiology
D000319:Adrenergic beta-Antagonists; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin