Evidence map›Paper›PMID 30698766›Full record

ArticleEuropean heart journal2019

Association between time of hospitalization with acute myocardial infarction and in-hospital mortality.

Jianhua Wu, Marlous Hall, Tatendashe B Dondo, Chris Wilkinson, Peter Ludman, Mark DeBelder, Keith A A Fox, Adam Timmis, Chris P Gale

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In one paragraph

Article in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Jianhua WuDivision of Applied Health and Clinical Translation, School of Dentistry, University of Leeds,Leeds, UK.
Marlous HallDepartment of Clinical and Population Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds UK.
Tatendashe B DondoDepartment of Clinical and Population Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds UK.
Chris WilkinsonDepartment of Clinical and Population Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds UK.
Peter LudmanCardiology Department, University Hospitals Birmingham, NHS Foundation Trust, Birmingham, UK.
Mark DeBelderDepartment of Cardiology, The James Cook University Hospital, Middlesbrough, UK.
Keith A A FoxCentre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
Adam TimmisNIHR Cardiovascular Biomedical Research Unit, Barts Heart Centre, London, UK.
Chris P GaleDepartment of Clinical and Population Sciences, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds UK.

Funding

Wellcome Trust 206470Wellcome Trust 206470/Z/17/Z
6 · The paper itself

Abstract

aimsTo study the association between time of hospitalization and in-hospital mortality for acute myocardial infarction (AMI). METHODS AND

resultsPatients admitted with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) across 243 hospitals in England and Wales between 1 January 2004 and 31 March 2013 were included. The outcome measure was in-hospital mortality. Adjusted odds ratios (ORs) for in-hospital mortality were estimated across six 4-hourly time periods over the 24-h clock using multilevel logistic regression, inverse-probability weighting propensity score, and instrumental variable analysis. Among 615 035 patients [median age 70.0 years, interquartile range 59.0-80.0 years; 406 519 (66.0%) men], there were 52 777 (8.8%) in-hospital deaths. At night, patients with NSTEMI were more frequently comorbid, and for STEMI had longer symptom-onset-to-reperfusion times. For STEMI, unadjusted in-hospital mortality was highest between 20:00 and 23:59 [4-h period range 8.4-9.9%; OR compared with 00:00-03:59 reference 1.13, 95% confidence interval (CI) 1.07-1.20], and for NSTEMI highest between 12:00 and 15:59 (8.0-8.8%; OR compared with 00:00-03:59 reference 1.07, 95% CI 1.03-1.12). However, these differences were only apparent in the earlier years of the study, and were attenuated by adjustment for demographics, comorbidities, and clinical presentation. Differences were not statistically significant after adjustment for acute clinical treatment provided.

conclusionThere is little evidence to support an association between time of hospitalization and in-hospital mortality for AMI; variation in in-hospital mortality may be explained by case mix and the use of treatments.

Indexed as

Acute DiseaseAgedAged, 80 and overComorbidityEnglandFemaleHospitalizationHospital MortalityHumansMaleMiddle AgedMyocardial InfarctionNon-ST Elevated Myocardial InfarctionOutcome Assessment, Health CareST Elevation Myocardial InfarctionTime FactorsAcute myocardial infarctionIn-hospital mortalityTime of hospitalization

Identifiers

PMID30698766
PMCPMC7618232

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.