Abstract 14962: Weekend versus Weekday Admission and Morality from Acute Coronary Syndrome
Introduction: ACS is a common condition requiring urgent diagnosis and intervention. Previous smaller studies show poor outcomes for time-sensitive medical conditions during weekend admissions, however whether these associations persist is not known.
Hypothesis: We assessed in-hospital mortality and utilization of invasive cardiac procedures following acute coronary syndrome (ACS) admissions on the weekend versus weekdays in the United States.
Methods: We used the 2009 Nationwide Inpatient Sample to examine differences in all-cause in-hospital mortality between weekend versus weekday admitted patients with a principal diagnosis of ACS. Adjusted logistic regression and hierarchical logistic regression analyses were used to identify if weekend admission was associated with decreased utilization of procedural intervention and increased subsequent complications as well.
Results: We identified 1054674 ACS admissions of which 22.1% were weekend admissions. Adjusted mortality for patients with NSTEMI was higher for weekend admissions [OR: 1.13; 95%CI: 1.10-1.16] and patients were significantly less likely to receive percutaneous coronary intervention, coronary artery bypass grafting, thrombolytic therapy, or coronary angiography on their first day of admission [OR: 0.68, 95%CI: 0.66-0.69]. Further, for weekend admitted ACS patients who underwent procedural interventions, in-hospital mortality and complications were higher compared to weekday admitted patients. Weekend admitted patients remained significantly less likely to receive a PCI, CABG, thrombolytic therapy, or coronary angiography (Adjusted OR: 0.73, 95% CI: 0.72-0.74).
Weekend admission was associated with longer hospital stay for NSTEMI patients. (Length of stay>3 days: OR: 1.20 (95%CI: 1.18-1.22).
Conclusions: For ACS patients, weekend admission is associated with higher mortality and lower utilization of invasive cardiac procedures, and those who did undergo these interventions had higher rates of mortality and complications than their weekday counterparts. We speculate that access to diagnostic and interventional procedures maybe contingent on decreased staff and lower weekend coverage that may impact regular workflow.
Author Disclosures: M. Khoshchehreh: None. E. Groves: None. D. Tehrani: None. S. Malik: None.
- © 2014 by American Heart Association, Inc.