Faculty Collaboration Database

Comparison of Inhospital Mortality and Frequency of Coronary Angiography on Weekend Versus Weekday Admissions in Patients With Non-ST-Segment Elevation Acute Myocardial Infarction. Am J Cardiol 2016 Sep 01;118(5):632-4

Date

07/07/2016

Pubmed ID

27381668

DOI

10.1016/j.amjcard.2016.06.022

Scopus ID

2-s2.0-84999025123 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

Patients with myocardial infarction admitted on weekends have been reported to less frequently undergo invasive angiography and experience poorer outcomes. We used the Nationwide Inpatient Sample database (2003 to 2011) to compare differences in all-cause inhospital mortality between patients admitted on a weekend versus weekday for an acute non-ST-segment elevation myocardial infarction (NSTEMI) and to determine if rates and timing of coronary revascularization contributed to this difference. A total of 3,625,271 NSTEMI admissions were identified, of which 909,103 (25.1%) were weekend and 2,716,168 (74.9%) were weekday admissions. Admission on a weekend versus weekday was independently associated with lower rates of coronary angiography (odds ratio [OR] 0.88; 95% confidence interval [CI] 0.89 to 0.90; p <0.001) or utilization of an early invasive strategy (EIS) (OR 0.480; 95% CI 0.47 to 0.48; p <0.001). Unadjusted inhospital mortality was significantly higher for the cohort of patients admitted on weekends (adjusted OR 1.02; 95% CI 1.01 to 1.04; p <0.001). However, this disparity was no longer significant after adjustment for differences in rates of utilization of EIS (OR 1.01; 95% CI 0.99 to 1.03; p = 0.11). In conclusion, this study demonstrates that among patients admitted with a diagnosis of an acute NSTEMI, admission on a weekend was associated with higher inhospital mortality compared with admission on a weekday and that lower rates of utilization of EIS contributed significantly to this disparity.

Author List

Agrawal S, Garg L, Sharma A, Mohananey D, Bhatia N, Singh A, Shirani J, Dixon S

Author

Divyanshu Mohananey MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

After-Hours Care
Aged
Aged, 80 and over
Coronary Angiography
Female
Hospital Mortality
Humans
Length of Stay
Male
Middle Aged
Non-ST Elevated Myocardial Infarction
Patient Admission
Patient Discharge
Percutaneous Coronary Intervention
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
United States