- The Washington Times - Monday, March 8, 2004

A medical study released yesterday showed that heart attack patients admitted to hospitals around the Christmas and New Year’s holidays are less likely to live than during the rest of the year.

The Duke University cardiologist who led the study said lower staffing levels at hospitals during the holidays likely resulted in a lower standard of care. Many of the patients studied died because they had not been given the best medicine available.

“We have to have hospitals running 24 hours, seven days a week. When you walk in the hospital you shouldn’t be able to know whether it’s 2 in the morning or 2 in the afternoon,” said Dr. Trip Meine, the lead cardiologist.

The study examined data on 134,609 heart attack patients admitted at hospitals nationwide from 1994 to 1996. He and his team compared mortality rates for patients admitted during the last two weeks and first two weeks of each year with mortality rates for patients admitted during the rest of the year.

The mortality rate for patients admitted during the holidays was 22.5 percent, compared with 20.5 percent for the rest of the year.

The main reason for this, Dr. Meine said, is that fewer angioplasties were performed on heart attack patients. The two possible treatments for a heart attack are blood clot-busting drugs or angioplasty. An angioplasty uses a small balloon that is inserted into an artery to open it up and allow blood flow to the heart.

“We know that angioplasty saves lives,” Dr. Meine said. “If fewer people get angioplasty, more people are going to die from heart attacks. If the staff isn’t in … then they’re not going to be able to do the procedure.”

Dr. Meine said it’s been proven that on weekends and during nights, “care is different. We suspected that holidays would be the same. It makes sense. It’s what we’d always suspected, but nobody had ever looked at it before.”

He presented the study yesterday at the annual conference of the American College of Cardiology in New Orleans. Dr. Meine said the study was well-received.

“The overall mortality rate during the time period is still quite low. We’re still doing a pretty dadgum good job in the U.S. of taking care of heart attacks,” Dr. Meine said.

Administrators at Johns Hopkins Hospital in Baltimore, which has the fourth-ranked cardiology program in the country, said they maintain the same staffing levels during the holidays as they do throughout the year.

“Leave can only be approved if there’s appropriate coverage,” said hospital spokeswoman Joanna Downer. She said Johns Hopkins does not track mortality rates during the holidays.

Washington Adventist Hospital officials also said their staffing levels remain the same year-round.

“We staff based on patient level. The staffing level does not vary based upon the time of year. The staffing level would be based on the number of patients we have,” said hospital spokesman Robert Jepson. “We diligently work months in advance of the holiday season to ensure that our staffing levels remain at the level they need to be, even during the holiday season.”

Hospital officials at Inova Fairfax Hospital said they maintained staffing levels appropriate to their patient volume.

Officials from the Cleveland Clinic, the top-rated cardiology unit in the country, and the Mayo Clinic in Minnesota, which ranks second, were in New Orleans for the conference and were unavailable for comment.

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