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.
