RJ MacFadyen
Journal Issue: 
Volume 44: Issue 2: 2014


This meta-analysis of publications over an approximate ten-year period from 2002–12 looked at mortality after coronary presentations. A total of 487 reports were studied and 48 were assessed for the impact of nominal ‘off hours’ (night and weekends) presentation for catheter-based revascularisation for ST elevation myocardial infarction (STEMI). Smaller studies tended to show increased mortality off hours, larger samples little or no adverse effect. The net impact, using a random effect meta-analysis model, was a statistically significant 2–4% mortality excess. This was linked by the authors to an increase in hospital ‘door to balloon’ times.