title: Evidence-based therapies and mortality in patients hospitalized in December with acute myocardial infarction.
abstract: 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.
authors.affiliation: Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Trip J
authors.initials: TJ
authors.lastname: Meine
authors.forename: Manesh R
authors.initials: MR
authors.lastname: Patel
authors.forename: Venita
authors.initials: V
authors.lastname: DePuy
authors.forename: Lesley H
authors.initials: LH
authors.lastname: Curtis
authors.forename: Sunil V
authors.initials: SV
authors.lastname: Rao
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Gersh
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Schulman
authors.forename: James G
authors.initials: JG
authors.lastname: Jollis
mesh_terms: 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
chemical_list: D000319:Adrenergic beta-Antagonists; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin