Clin Res Cardiol. 2016 Oct;105(10):865-72. doi: 10.1007/s00392-016-0995-8. Epub 2016 May 24.
- 1Department
of Cardiology, Lehigh Valley Hospital Network, 1250S Cedar Crest Blvd,
Suite 300, Allentown, PA, 18103, USA. Mahek.shah@lvhn.org.
- 2Department of Cardiology, Einstein Medical Center, Philadelphia, PA, USA.
- 3Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA.
- 4Sydney Kimmel Medical College, Philadelphia, PA, USA.
Abstract
INTRODUCTION:
Studies
suggest increased cardiac morbidity and heart failure exacerbations
during winter months with a peak around the holiday season. Major
sporting events and intense encounters in sports have been shown to
affect cardiovascular outcomes amongst its fans.
METHODS:
All
patients admitted to Einstein Medical Center between January 1, 2003
and December 31, 2013 with a diagnosis of congestive heart failure were
included in the study. They were included on the basis of the presence
of an ICD-9CM code representing congestive heart failure as the primary
diagnosis. Comparisons were made between the rates of heart failure
admissions on the holiday, 4 days following the holiday and the rest of
the month for 5 specific days: Christmas day, New Year's day, Independence day, Thanksgiving day and Super Bowl Sunday.
RESULTS:
Our
study included 22,727 heart failure admissions at an average of 5.65
admissions per day. The mean patient age was 68 ± 15 years. There was a
significant increase in daily heart failure admissions following
Independence day (5.65 vs. 5; p = 0.027) and Christmas
day (6.5 vs. 5.5; p = 0.046) when compared to the rest of the month. A
history of alcohol abuse or dependence did not correlate with the
reported+ rise in heart failure admissions immediately following the
holidays. The mean number of daily admissions on the holidays were
significantly lower for all holidays compared to the following 4 days.
All holidays apart from Super Bowl Sunday demonstrated lower admission
rates on the holiday compared to the rest of the month.
CONCLUSION:
Christmas
and Independence day were associated with increased heart failure
admissions immediately following the holidays. The holidays themselves
saw lower admission rates. Overeating
on holidays, associated emotional stressors, lesser exercise and
postponing medical around holidays may be among the factors responsible
for the findings.
KEYWORDS:
Christmas; Heart failure; Holiday; Independence day; New year; Over-eating; Super Bowl; Thanksgiving