Clinical Impact of Admission Day on Outcomes in Acutely Decompensated Aortic Stenosis: A Nationwide Analysis
2024

Impact of Admission Day on Outcomes in Aortic Stenosis

Sample size: 94320 publication 10 minutes Evidence: high

Author Information

Author(s): Bansal Nahush, Kwak Eun Seo, Alqadi Mohammad, Qiu Shuhao, Assaly Ragheb, Samanidis Georgios

Primary Institution: The University of Toledo

Hypothesis

Patients with acutely decompensated aortic stenosis may be particularly vulnerable to the 'weekend effect', where the day of admission impacts outcomes.

Conclusion

Patients with aortic stenosis admitted on weekends face significantly higher mortality, longer hospital stays, and increased complication rates compared to those admitted on weekdays.

Supporting Evidence

  • Weekend admissions were associated with significantly higher mortality (aOR 1.86; 95% CI 1.27–2.74).
  • Patients admitted on weekends had longer hospital stays, averaging 6.98 days compared to 3.80 days for weekdays.
  • Complication rates were higher on weekends, including cardiogenic shock and acute kidney injury.
  • Transcatheter aortic valve replacement rates were lower for weekend admissions (25.32%) compared to weekdays (39.6%).

Takeaway

If you go to the hospital for a heart problem on the weekend, you might not get the best care, which can make you sicker.

Methodology

Retrospective cohort study using the National Inpatient Sample database focusing on patients admitted with decompensated aortic stenosis.

Potential Biases

Potential misclassification bias due to reliance on administrative data.

Limitations

The study is retrospective and relies on ICD-10 codes, which may lead to misclassification bias and does not allow for accurate assessment of disease severity.

Participant Demographics

Patients included were adults hospitalized in 2020, with a higher proportion of weekend admissions being Hispanic and African American.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI 1.27–2.74

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.3390/jpm14121118

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