Disparity no longer significant after adjustment for utilization of early invasive strategy
FRIDAY, Aug. 26, 2016 (HealthDay News) — For patients with non-ST-segment elevation myocardial infarction (NSTEMI), weekend admission is associated with increased in-hospital mortality, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.
Sahil Agrawal, M.D., from St. Luke’s University Health Network in Bethlehem, Penn., and colleagues used the Nationwide Inpatient Sample database to compare differences in all-cause in-hospital mortality for patients admitted on a weekend versus weekday for acute NSTEMI. A total of 3,625,271 NSTEMI admissions were identified: 25.1 and 74.9 percent were weekend and weekday admissions, respectively.
The researchers found that weekend versus weekday admission was independently associated with lower rates of coronary angiography (odds ratio [OR], 0.88; 95 percent confidence interval [CI], 0.89 to 0.90) or utilization of an early invasive strategy (EIS) (OR, 0.480; 95 percent CI, 0.47 to 0.48) (both P < 0.001). For the cohort of patients admitted on weekends, in-hospital mortality was significantly higher (adjusted OR, 1.02; 95 percent CI, 1.01 to 1.04). After adjustment for differences in rates of utilization of EIS, the disparity was no longer significant (OR, 1.01; 95 percent CI, 0.99 to 1.03).
“This study demonstrates that among patients admitted with a diagnosis of an acute NSTEMI, admission on a weekend was associated with higher in-hospital mortality compared with admission on a weekday, and that lower rates of utilization of EIS contributed significantly to this disparity,” the authors write.
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