“Is there any chance I can go home?” Covering the cardiology and intensive care unit overnight on December 24, this is the most common question I am asked. Chances are if you have been referred to me, you are probably not going anywhere for a while. But the emergency room waiting area is eerily quiet. Having worked a number of shifts on-call during the holiday season, I have noticed that December 24 is often very quiet. Other doctors around me seem to share a similar sentiment. December 25 and 26 is often greeted with pandemonium.

Turns out that large population-based studies have demonstrated that Christmas and New Years are associated with some of the highest number of deaths from cardiovascular causes compared with any other time of the year. Examining national death data from 53 million people over 1973 to 2001, Phillips and colleagues examined the patterns of death from cardiovascular disease around the holiday season. They found distinct spikes in the number of deaths around Christmas and new years. Specifically, more cardiac deaths occur on December 25th compared to any other day of the year. The second largest number of cardiac deaths occur on December 26th, followed by January 1. In addition, during these time periods, there is a significant rise in the number of individuals who die immediately on presentation to the ER or even before making it to the ER. The number of people who are dying during the holiday season has also been increasing over the years. While there are inherent limitations in such an analysis, the consistent trends seen year after year paints a convincing picture that more people die over the holiday season. Other studies have also demonstrated similar trends.

There are a number of possible reasons for this increase in death. Colder weather may play a role; however, the effect of the holiday season on death appeared to be consistent across the United States. There may be an increasing burden of deaths triggered by respiratory infections, as is common during the holiday season. Another explanation are significant changes in diet and alcohol consumption during the holiday season. And among other reasons, delays in seeking medical attention likely plays a significant role in the increased number of deaths. Many of my patients who present with heart attacks, heart failure, or strokes admit that they would have come sooner had it not been for the holidays. Thoughts of inconveniencing family and friends, not wanting to miss the holidays, and ignoring important warning symptoms are common.

If you are feeling unwell or are concerned, do not delay. Seek medical attention. While you would miss out on spending time with you family and friends, at least you will be around to see them in the years to come.

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