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Deadly heart attacks are more common on a Monday

(www.bhf.org.uk)
239 points giuliomagnifico | 1 comments | 06 Jun 23 13:19 UTC | HN request time: 0s | source
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barbegal ◴[06 Jun 23 14:15 UTC] No.36213140[source]▶
The headline is misleading. The actual study proved that the recorded date of admission to hospital in Ireland with ST-segment elevation myocardial infarction was increased on a Sunday and Monday. Increased admissions on a Monday is not that unusual given that people often seek medical attention after the weekend but maybe more surprising is the increase on a Sunday. https://heart.bmj.com/content/109/Suppl_3/A78
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magicalhippo ◴[06 Jun 23 14:25 UTC] No.36213290[source]▶
Staffing tends to be lower on weekends AFAIK, could it be triggered by extra stress from not getting proper care during the weekend?

Another possible factor could be the fact that doctors tend to make more mistakes during operations on Fridays compared to start of week.

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haldujai ◴[06 Jun 23 14:31 UTC] No.36213392[source]▶
Not for a STEMI specifically, it’s one of two ECG patterns even a radiologist like me knows how to read. This is a stronger argument for other diseases. Door to balloon target in STEMI is 90 minutes.

STEMI centers (this is picked up by EMS and these ambulances are redirected to appropriate centers) have 24/7 cath lab coverage and any major one will have an ER bypass even during afterhours to expedite care.

In fact more and more hospitals (and all the major ones) announce a “Code STEMI” overhead either when the ambulance is dispatched or as soon as the ECG showing ST elevations is discovered in triage/ER to activate the team and reduce door-to-balloon time.

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selimthegrim ◴[06 Jun 23 16:27 UTC] No.36215245[source]▶
How common is it for a non-cardiologist know how to read ECGs? Is it something required in medical school? I heard a critique of Soviet medical training that nonspecialists didn’t know how to read them.
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OJFord ◴[06 Jun 23 16:52 UTC] No.36215674[source]▶
The basics definitely taught & required of all junior docs (UK) - but it's nuanced, not just a binary 'read an ECG correct or incorrect' - a specialist might spot something someone else doesn't; two specialists might disagree on whether it shows something or not. (And an interested (inherently non-specialist) junior might notice something a bored & rushed specialist doesn't.)
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antonjs ◴[06 Jun 23 17:14 UTC] No.36216023[source]▶
Seems like the perfect application for some kind of first pass (in the ambulance,even) automated ML diagnostic, given the data is 2D, well characterized, and mostly repeating.

Edit: aha--https://www.nature.com/articles/s41467-020-15432-4

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1. haldujai ◴[06 Jun 23 17:24 UTC] No.36216144[source]▶
We've had computer-reads/AI on ECGs since I was a medical student. Really good at detecting normal, bad at everything else.

US/Can healthcare systems still pay a cardiologist a couple of bucks to "finalize" the interpretation whenever they get around to it. It's a bit ironic, someone could have an MI on Friday, get treated and discharged and we're still paying someone on the Monday to read 40 ECGs (note these would have been acutely interpreted by the cardiologist treating the patient, most places have rules against self-referrals so you can't formally interpret anything you order yourself).