Cardiac Outcomes Better When the Doctor Is Away

A lower percentage of cardiac arrest patients who were admitted to teaching hospitals during national cardiology meetings died within 30 days compared with patients admitted on non-meeting days, according to a new study in JAMA Internal Medicine.

Researchers led by Anupam Jena, MD, PhD, assistant professor of healthcare policy at Harvard Medical School, analyzed 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction, heart failure, or cardiac arrest from 2002 through 2011. They compared data during the dates of 2 national cardiology meetings (American Heart Association and American College of Cardiology) with identical non-meeting days in the 3 weeks before and after the conferences.

According to the data, 60% of patients with cardiac arrest admitted to teaching hospitals during scientific meetings died within 30 days compared with 70% admitted on days there were no large cardiology conferences.

“That’s a tremendous reduction in mortality, better than most of the medical interventions that exist to treat these conditions,” Dr Jena, who is also an internist at Massachusetts General Hospital and a faculty research fellow at the National Bureau of Economic Research, said in a statement.

Although survival rates at teaching hospitals for high-risk heart failure and cardiac arrest patients were up during meetings, there was no difference in mortality for patients with high-risk heart attack or low-risk patients with other conditions studied. Mortality rates for patients with any of the conditions studied were unchanged in nonteaching hospitals during meeting and non-meeting dates.

Dr Jena said the results suggest that a “less is more” approach could be best for high-risk patients with certain heart conditions. During meeting dates, certain intensive procedures were performed less often on the high-risk patients.

According to the authors, one explanation for the differing mortality rates may be that physicians who do not attend conferences are more conservative in their care for high-risk patients, and another possibility may be that physicians who did not attend the meeting were reluctant to perform intensive procedures on the patients of physicians who were out of town attending the conference.

Overall, the authors had expected to find outcomes were worse during conferences when physicians were out of town, and were surprised by the results, according to Harvard Medical School.