• Int. J. Cardiol. · Jan 2015

    Effect of weekend admission for acute myocardial infarction on in-hospital mortality: a retrospective cohort study.

    • Toshiaki Isogai, Hideo Yasunaga, Hiroki Matsui, Hiroyuki Tanaka, Tetsuro Ueda, Hiromasa Horiguchi, and Kiyohide Fushimi.
    • Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Cardiology, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8524, Japan. Electronic address: toisogai-circ@umin.ac.jp.
    • Int. J. Cardiol. 2015 Jan 20; 179: 315-20.

    BackgroundNo previous nationwide study has examined whether there is a 'weekend effect' of higher mortality after admission for acute myocardial infarction (AMI) when percutaneous coronary intervention (PCI) is easily accessible.MethodsUsing the Diagnosis Procedure Combination inpatient database in Japan, we identified AMI patients aged ≥20 years who were admitted to acute care hospitals between July 1, 2010 and March 31, 2013. Multivariable regression models fitted with generalized estimating equations were used to determine the association between weekend admission and in-hospital mortality. Eligible patients were also classified into subgroups according to Killip class at admission.ResultsOf 111,200 eligible patients, 30,847 patients were admitted on weekends and 80,353 patients on weekdays. Overall, the in-hospital mortality was significantly higher for weekend admission than for weekday admission (13.6% versus 11.4%; P<0.001; unadjusted odds ratio [OR] 1.222; 95% confidence interval [CI] 1.172 to 1.274), despite the higher rate of PCI performed on the day of admission (68.9% versus 64.8%; P<0.001). The association remained significant after adjusting for baseline characteristics, invasive procedures, and medications (adjusted OR 1.144, 95% CI 1.079 to 1.214). In subgroup analyses, the effect of weekend admission remained significant in the Killip II to IV subgroups, but became insignificant in the Killip I subgroup (adjusted OR 1.002, 95% CI 0.828 to 1.213).ConclusionsThis study showed that weekend admission for AMI was significantly associated with higher in-hospital mortality even in a setting where PCI was highly available.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…