In a rather bizarre finding, analysis of nearly one million heart failure cases in hospitals has shown that death and length of hospitalisation are highest in patients admitted in January, or on Fridays, or in the night.
The analysis of 949,907 hospitalisations for congestive heart failure admissions over 14 years (1994 to 2007) in all hospitals in New York state in US was presented by Dr David P. Kao from Denver, Colorado at the Heart Failure Congress 2013 at Lisbon. The event was organised by the European Society of Cardiology (ESC).
As expected, the researchers found that daily heart failure admissions increased significantly over this period while in-hospital death and length of stay decreased.
"These findings confirm the huge decline in mortality in hospitals for heart failure over the past 14-15 years following major advances in therapy," Dr Kao said, in a statement by the ESC.
But the startling findings related to month, day and hour of admission. Daily heart failure admissions peaked in February, while in-hospital death and length of stay peaked in January. Death and length of stay were lowest for admissions in the morning, between 6 am and 12 noon but became highest overnight for admissions between 6 pm and midnight by a small margin, according to the ESC statement.
The research also found that chances of death and length of stay were lowest in patients admitted on Monday and highest on Friday, the study said.
The findings suggest that staffing may have an impact on seasonal variations in mortality and length of stay.
"The fact that patients admitted right before the weekend and in the middle of the night do worse and are in hospital longer suggests that staffing levels may contribute to the findings," Dr Kao said
"Doctors and hospitals need to be more vigilant during these higher risk times and ensure that adequate resources are in place to cope with demand. Patients should be aware that their disease is not the same over the course of the year and they may be at higher risk during the winter. People often avoid coming into hospital during the holidays because of family pressures and a personal desire to stay at home but they may be putting themselves in danger," Dr Kao said.