Published: 11/21/2005
A study published in the October 4 issue of Annals of Internal Medicine shows that elderly patients admitted to the hospital with heart attacks in the month of December have higher death rates than those with heart attacks in any other month.
This conclusion was reached after investigators analyzed data from Cooperative Cardiovascular Project, which has information on over 120,000 Medicare patients who were admitted to the hospital with heart attacks between January, 1994 and February, 1996. The investigators found that the 30-day mortality rate was significantly higher in patients admitted during the month of December, despite the fact that the care they received (as assessed by several evidence-based quality measures also available in the database) was of equally high quality in December as compared with any other month.
The reason that December heart attacks appear more deadly is not clear. The cause does not appear to be related to a lower quality of care, since by objective measures the quality of care appeared to be maintained in the month of December. Some speculate that the generally increased rate of depression seen around the holidays may be playing a role in the higher mortality. Perhaps having a heart attack during the holidays is itself especially depressing, and the resultant "extra" depression increases the risk of dying. But more likely (at least it seems more likely in DrRich's experience,) patients with symptoms of a heart attack in December are prone to try just wishing the symptoms away, or attributing them to some other cause (overeating, stress, etc.,) since, how can it be a heart attack? It's Christmas! Such willful ignoring of the symptoms goes on until the symptoms simply can be no longer ignored. By that time, patients arrive in the hospital much later during the course of their heart attacks than they would at other times of the year. And since time is of the essence in treating a heart attack, doctors may just be seeing a sicker group of patients than they do during the non-holiday seasons.
The moral: Just because it's the holidays doesn't mean you can't be having a heart attack. If you have the symptoms, get immediate medical care.
