Bioethics Blogs

Some Older Hospitalized Heart Patients May Fare Better During Times Cardiologists Are Away Attending Their National Meetings?

On December 22, 2014, JAMA Internal Medicine published an
article online titled “Mortality and Treatment Patterns Among Patients
Hospitalized With Acute Cardiovascular Conditions During Dates of National
Cardiology Meetings
.”
A note by the journal’s editor Rita F. Redberg, MD, MSc, a cardiologist, titled
“Cardiac Patient Outcomes During National Cardiology Meetings” appeared the
same day. [
JAMA Intern Med. Published online December 22, 2014.
doi:10.1001/jamainternmed.2014.6801] Also, the same day press reports appeared –
among other news outlets – in The New
York Times
, Los Angeles Times, and on the Web
pages of the Harvard Medical School
 commenting on
these articles. The newspaper articles and press release titles are more tantalizing:
“Do Heart Patients Fare Better When Doctors Away?”; “Some Heart Patients Do
Better When the Cardiologist Is Away”; and “Startling Benefit of Cardiology
Meetings.”

In perhaps one
of the most terse and one of briefest-ever conclusion sections found in a significant
medical journal article of this length and with such extensive empirical data, authors
Jena et. al said: “We observed lower 30-day mortality among patients with
high-risk heart failure or cardiac arrest admitted to major teaching hospitals
during the dates of 2 national cardiology meetings, as well as substantially
lower [percutaneous coronary intervention] rates among high-risk patients with
[acute myocardial infarction], without any detriment to survival. One
explanation for these findings is that the intensity of care provided during
meeting dates is lower and that for high-risk patients with cardiovascular
disease, the harms of this care may unexpectedly outweigh the benefits.”

In the Harvard
Medical School News Release, reporter Jake Miller said: “Sixty percent of
patients with cardiac arrest who were admitted to a teaching hospital during
the days when cardiologists were at scientific meetings died within 30 days,
compared to 70 percent of patients who were admitted on non-meeting days.” He
also said, “While survival rates at teaching hospitals went up during meeting
days for high-risk heart failure for cardiac arrest, there was no difference in
mortality between meeting and non-meeting days for patients with high-risk
heart attack or for low-risk patients with any of the conditions studied.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.