Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings

Importance: Thousands of physicians attend scientific meetings annually.  Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown.

Objective: To analyze differences in mortality and treatment utilization among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared to non-meeting dates.

Design, Setting, and Participants: Retrospective analysis of 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure, or cardiac arrest from 2002-2011 during dates of two national cardiology meetings compared to identical non-meeting days in the three weeks before and after conferences (AMI, 8570 hospitalizations during meetings, 57471 during non-meetings; heart failure, 19282 during meetings, 114591 during non-meetings; cardiac arrest, 1564 during meetings, 9580 during non-meetings).  Multivariate analyses were conducted separately for major teaching hospitals and non-teaching hospitals and for low- and high-risk patients.  Differences in several utilization measures were assessed. 

Main outcome measures: 30-day mortality, procedure rates, hospital charges, and length of stay

Results: Patient demographics and comorbidities were comparable between meeting and non-meeting dates.  In teaching hospitals, unadjusted 30-day mortality was lower among admissions during meeting dates versus non-meeting dates for high-risk heart failure (17.0% (66/388) vs 24.8% (535/2154), p<0.001) and cardiac arrest (59.0% (98/166) vs 68.6% (669/975), p=0.02).  Mortality rates were no different for high-risk AMI in teaching hospitals between meeting and non-meeting dates, however, adjusted PCI rates were lower during meetings (20.8% vs 28.2%, p=0.02).  No differences in mortality or utilization were noted in non-teaching hospitals.  Results were unaffected by covariate adjustment.  In sensitivity analyses, cardiac mortality was not affected by hospitalization during oncology/gastroenterology/orthopedics meetings, nor was gastrointestinal hemorrhage or hip fracture mortality affected by hospitalization during cardiology meetings.

Conclusions and relevance: High-risk heart failure and cardiac arrest patients hospitalized in teaching hospitals had significantly lower mortality when admitted during dates of national cardiology meetings.  High-risk AMI patients admitted during meetings were less likely to receive PCI, without any effect on 30-day mortality.