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Christmas Day is
Deadliest of the Year, Says 26-Year Study
Increasing number of
deaths occurring during holiday season
Dec. 21, 2004 –
Christmas is the deadliest day of the year, say researchers who examined
records of 53 million deaths from natural causes over a 26-year period
(1973-2001). Cardiac and non-cardiac deaths peak during Christmas and
News Year’s, they say, and suggest it may be because people, many senior
citizens, are delaying
getting medical treatment because of the holidays.
See tips on safety by American Heart Association
at bottom of news story.
In Dead-On-Arrival
emergency departments and outpatient groups, more cardiac deaths
occurred on Dec. 25 than on any other day of the year. The
second-largest number of deaths was on Dec. 26, and the third-largest
number was on Jan. 1. For patients who survived past the emergency
department to be hospitalized, there was no obvious double spike at
Christmas and New Year’s Day, although there was a general increase
during the holiday period and just afterwards.
In the
DOA/ED/outpatient group, 4.65 percent more cardiac deaths and 4.99
percent more non-cardiac deaths occurred during the holiday period than
would be expected from the season without the holiday effect. For
inpatients, the cardiac holiday effect was 1.6 percent more.
The report was
published last week in Circulation: Journal of the American Heart
Association. It excluded suicides, homicides and accidents.
They compared the
number of deaths during the holiday period, which they defined as Dec.
25 to Jan. 7, to the number of deaths that would be expected at that
time of year if deaths from natural causes were unaffected by the
holidays.
“We found that there is
a general tendency for cardiac and non-cardiac deaths to peak during the
winter, but above and beyond this seasonal increase, there are
additional increases in cardiac and non-cardiac deaths around Christmas
and New Year’s,” said lead author David P. Phillips, Ph.D., professor,
department of sociology, University of California at San Diego, La
Jolla, Calif.
“These twin mortality
spikes are particularly striking if you look at a subset of heart deaths
where people are dead on arrival (DOA), die in the emergency department
(ED) or die as outpatients.”
The researchers also
found that the percentage of holiday deaths is growing proportionately
over time. In the latest three years studied, observed holiday
mortality was 4.4 percent above what was expected for the winter
months. In the earliest three years of the study, holiday mortality was
0.95 percent above expected.
The authors estimated
that during the Christmas-New Year holidays, there were about 42,039
more deaths during the 26-year study period than would be expected
without the “holiday effect.”
“Of all the things we
considered that might elicit the increase in holiday deaths from natural
causes, including changes in diet and alcohol consumption and emotional
stress, only two explanations were consistent with our data,” Phillips
said. “One possibility is that sick people tend to delay seeking
medical care during the holidays. Another is that there are often
changes in medical staff during the holidays and, as a result, the
quality of care might be compromised.”
Phillips’ work is an
expansion of a 1999 report by Robert A. Kloner, M.D., Ph.D., who wrote
an editorial about Phillips’ report. In his report, Kloner analyzed 12
years of data from Los Angeles County and found about 33 percent more
deaths occurred in December and January than in June through September,
with deaths peaking on Jan. 1.
Kloner is a professor
in the division of cardiovascular medicine in the Keck School of
Medicine at the University of Southern California in Los Angeles, and
director of research at the Heart Institute at Good Samaritan Hospital.
In his editorial, he wrote that the research is now definitive and
includes nationwide data over a longer period.
Kloner suggested that
overindulgence, emotional stress and respiratory problems could also
lead to more deaths. The increased use of fireplaces during the
holidays may lead to increased inhalation of airborne particulate
matter.
People and healthcare
providers can be prudent during the holiday season to help diminish this
phenomenon, Kloner said. “Consumers should seek professional help
immediately if they have cardiac symptoms, and they should try to see
their usual health care providers,” he said.
In response to this
trend in increased death rates, Kloner said, “Coronary care units and
emergency wards should be adequately staffed for the potential increase
in patients.”
Tips
to Keep Heart Healthy During Holidays
Alice Jacobs, M.D.,
president of the American Heart Association, said these tips can help
keep your heart healthy during the holidays:
-
Don’t skip regular appointments because of the
holidays. Reschedule if you need to.
-
Stick to your healthy habits through the
holidays, and help your family do the same.
-
Be sure you have enough of your usual
medications to allow for holiday business/pharmacy closings and
travel.
-
Check out the medical facilities where you’ll
be traveling. Ask your physician who you could see if you need a
doctor away from home.
-
If you have symptoms, don’t ignore them.
Co-authors with
Phillips are Jason R. Jarvinen, B.A.; Ian S. Abramson, Ph.D.; and
Rosalie R. Phillips, M.P.H.
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