Comments on: Don’t have a heart attack on the weekends http://www.kevinmd.com/blog/2007/03/dont-have-heart-attack-on-weekends.html Tue, 14 Feb 2012 19:56:00 +0000 hourly 1 By: Michael Rack, MDhttp://www.kevinmd.com/blog/2007/03/dont-have-heart-attack-on-weekends.html#comment-72987 Michael Rack, MD Sun, 18 Mar 2007 05:51:00 +0000 http://clients.emmense.com/kevinmd/2007/03/dont-have-a-heart-attack-on-the-weekends.html#comment-72987 "Myocardial infarction has a very strong diurnal variation with both the timing as well as the severity of the disease varying throught the day. Why should it not also vary throughout the week also?"<br/>Because there is a biologically based 24 hour circadian rhythm. The designation of 7 consecutive days as being a week is a historical accident and has no biological basis. “Myocardial infarction has a very strong diurnal variation with both the timing as well as the severity of the disease varying throught the day. Why should it not also vary throughout the week also?”
Because there is a biologically based 24 hour circadian rhythm. The designation of 7 consecutive days as being a week is a historical accident and has no biological basis.

]]> By: Gasmanhttp://www.kevinmd.com/blog/2007/03/dont-have-heart-attack-on-weekends.html#comment-72900 Gasman Thu, 15 Mar 2007 18:12:00 +0000 http://clients.emmense.com/kevinmd/2007/03/dont-have-a-heart-attack-on-the-weekends.html#comment-72900 These studies try to use acute events that presumably have no relationship to the day of week as to their occurance. The assumption then is that any difference in outcome is the result of the care and not the patient or nature of their disease.<br/><br/>I can almost buy this assumption for hemorrhagic stroke, but who knows, even here there might be some temporal bias in terms of when people bleed, when they might be more hypertensive etc. Myocardial infarction has a very strong diurnal variation with both the timing as well as the severity of the disease varying throught the day. Why should it not also vary throughout the week also? <br/><br/>These studies try to improve care by noting that coverage on weekends is suboptimal. The methodology is good but not perfect. These studies try to use acute events that presumably have no relationship to the day of week as to their occurance. The assumption then is that any difference in outcome is the result of the care and not the patient or nature of their disease.

I can almost buy this assumption for hemorrhagic stroke, but who knows, even here there might be some temporal bias in terms of when people bleed, when they might be more hypertensive etc. Myocardial infarction has a very strong diurnal variation with both the timing as well as the severity of the disease varying throught the day. Why should it not also vary throughout the week also?

These studies try to improve care by noting that coverage on weekends is suboptimal. The methodology is good but not perfect.

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