Incidence, admission and case-fatality of acute myocardial infarction: weekend versus weekday in a Japanese population: 16-year results from Takashima AMI Registry (1988-2003).
ABSTRACT For acute myocardial infarction (AMI), "weekend" has been associated with higher incidence, admission, and fatality. But, very few studies in this regard are available in Japan. Day of the week variation in AMI was examined using an entire community covering 16-year AMI registration data from Japan. Data were obtained from the Takashima AMI Registry, which covers a stable population of approximately 55,000 in central Japan. There were 379 registered first ever AMI cases with 121 fatal events within 28 days of onset during 1988-2003. We divided the days into two groups: 'Weekend' (Saturday and Sunday) and 'Weekdays' (Monday to Friday). The incidence rate (per 100,000 person-year), admission rate (per 1,000 days) and 28-day case-fatality rates (per 100 events) as well as corresponding rate ratios were calculated with 95% confidence intervals. The distribution of the day of the week for onset, admission and fatality for all subjects was fairly random in our study population; incidence (chi (2) test, P = 0.8), admission (chi (2) test, P = 0.9) and case-fatality (chi (2) test, P = 0.8). The incidence, admission, and case-fatality rates were similar for the 2 day-groups. The incidence rate ratio 1.06 (95% CI: 0.9-1.3), admission ratio 1.03 (95% CI: 0.8-1.3), and case-fatality ratio 1.18 (95% CI: 0.7-1.9) showed no significant risk difference between weekend and weekday. After various adjustments, hazard ratio for weekend AMI in reference to weekday AMI was 1.07 (95% CI: 0.5-2.1). There were no obvious differences in occurrence, hospital admission and acute outcome for AMI patients in the weekday or weekend.
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ABSTRACT: It remains controversial, whether spectators of soccer matches are exposed to an increased risk of cardiac events. In 2006, the Soccer World Cup (SWC) took place in Germany and provided an excellent opportunity to assess the effects of emotional stress on cardiac events in a large cohort of soccer enthusiasts in the region of Bavaria. We analyzed data from the Bavarian Council for Statistics and Data Management for the period of SWC (June 9-July 9, 2006) and reference periods (SWCRef; May 1-July 31, 2005; May 1-June 8, 2006 and July 10-31, 2006) for the following diagnoses: myocardial infarction; myocardial re-infarction; cardiac arrest; paroxysmal tachycardia; atrial fibrillation, atrial flutter; all remaining tachyarrhythmias. Data were compared to the seven days during the tournament, on which the German team played (SWCGerman), the rest of the SWC period (i.e. the days the German team did not play, 24days, SWCRest) and SWCRef (61days). There was neither a significant increase (p>0.433) in total cardiac events in Bavaria per day during SWCGerman (161.1±46.7) or SWCRest (170.5±52.3) as compared to the SWCRef (176.2±51.8), nor in any investigated diagnosis. After controlling for age, gender, loss of a match, outside temperature and nitric-dioxide air pollution levels the results remained essentially unchanged. Watching soccer was not associated with an increased incidence of cardiac events, regardless of whether the home team played or not. These data further support the hypothesis that spectators of sporting events are not exposed to an increased risk of cardiac events.International journal of cardiology 10/2013; · 6.18 Impact Factor
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ABSTRACT: Background Few comprehensive stroke and acute myocardial infarction registries of long duration exist in Japan to illustrate trends in acute case-fatality of stroke and acute myocardial infarction with greater precision. We examined 17-year case-fatality rates of stroke and acute myocardial infarction using an entire community-monitoring registration system to investigate trends in these rates over time in a Japanese population.Methods Data were obtained from the Takashima Stroke and AMI Registry covering a stable population of approximately 55 000 residents of Takashima County in central Japan. We divided the total observation period of 17 years into four periods, 1989–1992, 1993–1996, 1997–2000, and 2001–2005. We calculated gender, age-specific and age-adjusted acute case-fatality rates (%) of stroke and acute myocardial infarction across these four periods.ResultsDuring the study period of 1989–2005, there were 341 fatal cases within 28 days of onset among 2239 first-ever stroke events and 163 fatal cases among 433 first-ever acute myocardial infarction events. The age-adjusted acute case-fatality rate of stroke was 14·9% in men and 15·7% in women. The age-adjusted acute case-fatality rate of acute myocardial infarction was 34·3% in men and 43·3% in women. The age-adjusted acute case-fatality rates of stroke and acute myocardial infarction showed insignificant differences across the four time periods. The average annual change in the acute case-fatality rate of stroke (−0·2%; 95% CI: −2·4–2·1) and acute myocardial infarction (2·7%; 95% CI: −0·7–6·1) did not change significantly across the study years.Conclusions The acute case-fatality rates of stroke and acute myocardial infarction have remained stable from 1989 to 2005 in a rural and semi-urban Japanese population.International Journal of Stroke 06/2014; · 4.03 Impact Factor
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ABSTRACT: Background Optimal care of multiple trauma patients has to be at a high level around the clock. Trauma care algorithms and guidelines are available, yet it remains unclear if the time of admission to the trauma room affects the quality of care and outcomes. Hence the present study intends to compare the quality of trauma room care of multiple severely injured patients at a level-1 trauma center depending on the time of admission.MethodsA total of 394 multiple trauma patients with an ISS¿¿¿16 were included into this study (observation period: 52 months). Patients were grouped by the time and date of their admission to the trauma room [business hours (BH): weekdays from 8:00 a.m. to 4:00 p.m. vs. non-business hours (NBH): outside BH]. The study analysed differences in patient demographics, trauma room treatment and outcome.ResultsThe study sample was comparable in all basic characteristics [mean ISS: 32.3¿±¿14.3 (BH) vs. 32.6¿±¿14.4 (NBH), p¿=¿0.853; mean age: 40.8¿±¿21.0 (BH) vs. 37.7¿±¿20.2 years (NBH), p¿=¿0.278]. Similar values were found for the time needed for single interventions, like arterial access [4.8¿±¿3.9 min (BH) vs. 4.9¿±¿3.4 min (NBH), p¿=¿0.496] and quality-assessment parameters, like time until CT [28.5¿±¿18.7 min (BH), vs. 27.3¿±¿9.5) min (NBH), p¿=¿0.637]. There was no difference for the 24 h mortality and overall hospital mortality in BH and NBH, with 13.5% vs. 9.1% (p¿=¿0.206) and, 21.9% vs. 15.4% (p¿=¿0.144), respectively. The Glasgow Outcome Scale (GOS) comparison revealed no difference [3.7¿±¿1.6 (BH) vs. 3.9¿±¿1.5 (NBH), p¿=¿0.305]. In general, the observed demographic, injury severity, care quality and outcome parameters revealed no significant difference between the two time periods BH and NBH.Conclusions The study hospital provides multiple trauma patient care at comparable quality irrespective of time of admission to the trauma room. These results might be attributable to the standardization of the treatment process using established principles, algorithms and guidelines as well as to the resources available in a level-1 trauma center.Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 10/2014; 22(1):62. · 1.93 Impact Factor