Night heart attack care 'worse'

Patients who have a heart attack during the night or at weekends have to wait longer for treatment and are more likely to die, a US study suggests.

The report in the Journal of the American Medical Association found these patients waited longer for clot-busting drugs and surgery.

The study of 102,000 patients concluded the risk of dying increased by 7% when patients were treated out of hours.

UK experts said NHS out-of-hours care was also likely to be slower.

Lead researcher David Magid said the delays were putting lives at risk.

The best way round this is to concentrate resources at certain centres to ensure they provide the best level of care Martin Shalley, A&E consultant

He said extra staffing at hospitals treating heart attack patients was needed, but admitted this was not always possible because of cost considerations.

"Another approach would be to regionalise interventional cardiac care," he added, taking out-of-hours patients to institutions which provided continuous care.

The researchers looked at the average time taken for a patient to be given procedures such as angioplasty, in which a catheter-guided balloon is used to open a narrowed coronary artery.

For people treated between 7am and 5pm, the time taken from when they left their homes was 95 minutes.

But for those affected at night or weekend it was 116 minutes, the study by Kaiser Permanente, a Denver-based not-for-profit health organisation, and Yale School of Medicine found.

Survival

It took 33 minutes to treat blood clots during the day, compared with a slight increase of 34 minutes out of hours.

The report said the shorter the time from symptom onset to treatment, the greater the survival benefit with either therapy.

About 268,000 people have a heart attack each year in the UK.

A&E consultant Martin Shalley, president of the British Association of Emergency Medicine, said the findings were not surprising.

"At night units staffing levels are not as high so it is understandable treatment is not as fast as at other times," he said.

"I think in the UK that will certainly be the case for angioplasty.

"The best way round this is to concentrate resources at certain centres to ensure they provide the best level of care, rather than spreading resources around."