Comparison of Outcomes Among Patients With Cardiogenic Shock Admitted on Weekends Versus Weekdays
Section snippets
Methods
The National Inpatient Sample (NIS) is a publicly available database available online at https://www.distributor.hcup-us.ahrq.gov. It is a stratified sample of 20% of discharges from United States hospitals and includes almost 8 million hospital discharges per year. It represents more than 95% of the United States hospitalizations from 44 states participating in the Healthcare Cost and Utilization Project. As the NIS constitutes a random 20% sample of hospital discharges, we used the available
Results
Over the 10-year time period from 2005 through 2014, there were 875,054 total hospitalizations with a diagnosis of CS; 666,931 patients were admitted on weekdays and 208,118 were admitted on weekends. Table 1 summarizes baseline demographics and co-morbidities by weekday versus weekend admission. Mean age was 67.4 ± 15.1 years, 40.2% were women, and 72.1% were Caucasian. Patients were predominantly admitted to large (70.0%) and urban teaching (60.0%) hospitals. There were significantly more
Discussion
This study of patients in a national multi-center inpatient registry examines trends in cardiogenic shock admissions over time and associations between weekend admission and subsequent in-hospital outcomes. Using this nationwide analysis from 2005 to 2014, we identified more than 875,000 admissions with primary or secondary diagnosis of CS; mortality was 38%, but decreased over the ten-year study period. More than 40% of patients admitted on weekends died prior to hospital discharge, as
Credit Author Statement
Ahmed A. Harhash, MD: conceptualization, writing – original draft; Kevin F. Kennedy, MS: software, methodology, formal analysis; Timothy J. Fendler, MD: writing – review & editing; Taiyeb M. Khumri, MD: writing – review & editing; Michael E. Nassif, MD: writing – review & editing; Anthony Magalski: writing – review & editing; Brett W. Sperry, MD: conceptualization, methodology, writing – review & editing, visualization, supervision.
Declaration of Interests
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgment
none
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Funding: No funding was available for this work.
Disclosures: All authors have reported no relationships relevant to the contents of this paper to disclose.
Tweet: Patients with #CardiogenicShock admitted on weekends had higher in-hospital mortality and were slightly less likely to receive mechanical support and advanced therapies compared with those admitted on weekdays.