A study has raised concerns about hospitals’ capacity to deliver high-quality care during major medical conferences after finding a mortality spike among heart attack patients admitted on the days of Australia’s largest cardiology meeting.
Writing in the Internal Medicine Journal [link here], cardiologists from Sydney’s Concord Hospital said hospital departments often operated on “a skeleton staff” during conferences, but little was known about the effect this had on patients.
They analysed acute myocardial infarction (AMI) presentations during the Cardiac Society of Australia and New Zealand (CSANZ) Annual Scientific Meeting from 2003-2021, using a NSW database for inpatients linked to the death registry.
There were 2809 AMI admissions on meeting days versus 21,952 controls (defined as admissions on the same days of the week within four weeks before or after the conference). The median age of patients was 72 and 64% were male.
Patients admitted during the CSANZ ASM had a significantly higher 30-day mortality after multivariable adjustment (OR: 1.18, 95% CI: 1.02–1.37, P= 0.02).
The researchers compared this to the “weekend effect”, in which patients admitted with AMI on the weekend have a 5%–13% higher mortality than on weekdays.
Overall, 318 (11.3%) ‘meeting day’ patients and 2134 (9.7%) controls died within 30 days (P= 0.008). There was no significant mortality difference by 6 months.
The study was underpowered to show a significant effect during individual years.
“These are observational data that do not prove a causal relationship between the CSANZ ASM and mortality after AMI, and we can only speculate on the possible reasons for the association,” the researchers said.
Among the potential contributors, they listed delay in coronary angiogram, lower prescription of prognostic therapy or misdiagnosis.
They noted their findings contrasted data from the US which showed 30-day mortality actually declined during cardiology meetings. They also acknowledged education, research and improved patient outcomes over the long term were potential benefits from doctors and other staff attending the scientific meetings.
“Nevertheless, the findings do cause some concern that the decreased staffing during the CSANZ ASM may delay some critical treatments or that the absence of leaders in cardiology may reduce the application of optimal evidence-based management strategies,” the researchers said.
“We do believe that increased attention on staffing during meetings is warranted. Currently neither conference organisers nor hospitals present data on attendance, and greater transparency of attendance and the drain from certain hospitals may be the first step to exploring whether the spike in mortality can be addressed.”