News | Cath Lab | May 15, 2017

Day of the Week PCI-Related Hospitalization Occurs Determines Likelihood of Survival

SCAI study demonstrates patients who have a heart attack on the weekend are more likely to die

Day of the Week PCI-Related Hospitalization Occurs Determines Likelihood of Survival, SCAI 2017

May 15, 2017 — In a large-scale analysis of percutaneous coronary intervention (PCI)-related hospitalizations, people admitted to the hospital on a weekend were twice more likely to die than those hospitalized on a weekday. Results from “Weekend Effect for Percutaneous Coronary Intervention Admissions: A 10-Year U.S. Experience” were presented at the Society for Cardiovascular Angiography and Interventions (SCAI) 2017 Scientific Sessions, May 10-13 in New Orleans.

Data was derived from the Nationwide Inpatient Sample database (2004-2013), the largest publicly available all-payer inpatient healthcare database in the United States. The cohort included 1,293,209 patients with PCI (weighted 6,360,503). Of those patients, most were male (66.4 percent) who were 50 or older (87.9 percent).

Data revealed that weekend admissions are on the rise, increasing from 12.4 percent in 2004 to 21.5 percent in 2013, with a relative change of 82.4 percent. Weekend admissions were associated with higher in-hospital mortality (2.1 percent versus 1.2 percent, p˂0.001), with a relative increase of 20.5 percent on the weekend versus 98.2 percent on the weekdays (p˂0.001).

Weekend admissions also were associated with longer hospital stays (4.2 days versus 2.9 days, p˂0.001) and higher cost of care ($23,630 versus $20,080, p˂0.001) compared to weekdays, though exhibiting a decline in duration of hospitalization (relative change -11.8 percent, p˂0.001) and cost of care (relative change -6.22 percent, p˂0.001).

“There is controversy about what is known as ‘the weekend effect,’ acknowledged Byomesh Tripathi, M.D., the study’s lead researcher and resident physician at Mount Sinai St. Luke’s and Mount Sinai West Hospital. “However, our sample is highly representative of the U.S., encompassing approximately 20 percent of the PCI population, and results are statistically significant.”

“Our study clearly showed that weekend admissions for PCI patients are associated with higher in-hospital mortality, though margins are closing in comparison to weekday admissions, and longer lengths of stay,” added Tripathi. “We speculate that better access to care on weekends could improve the outcome for patients undergoing PCI.”

Read about two related U.K. studies, "Two U.K. Studies Validate Weekend Effect Among Heart Patients."

Tripathi reported no disclosures.

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