A-35 | Percutaneous coronary intervention: A national analysis of the weekend effect

Previous studies have demonstrated that individuals admitted over the weekend for certain time-sensitive acute conditions, including acute myocardial infarction (AMI), face an increased risk of mortality compared to their counterparts admitted on weekdays. A retrospective cohort study was conducted utilizing the NIS database spanning from 2016 to 2020. Patients undergoing percutaneous coronary intervention (PCI) were identified using ICD-10 codes and stratified based on weekend versus weekday admission. Outcomes, encompassing mortality and in-hospital complications, were analyzed through multivariate logistic regression. A total of 2,367,870 patients underwent PCI, with 564,517 (23.8%) admitted during weekends. The weekend cohort was comparatively younger (64 vs. 65 years old, p < 0.001), with no significant difference in gender (32.3% vs. 32.8% female in the weekend vs. weekday group, respectively). After adjusting for potential confounders, the overall in-hospital relative risk of death was 15% higher in the weekend cohort compared to the weekday group [Adjusted Odds Ratio (aOR) = 1.15; 95% Confidence Interval (CI): 1.10-1.20, p-value < 0.001]. Secondary outcome analysis revealed a slightly prolonged length of stay [Coefficient: 0.28 days; 95% CI: 0.24-0.31, p < 0.001] and higher total hospital charges in the weekend group [Coefficient: 1194 USD; 95% CI: 363-2025, p = 0.005]. Regarding complications, the weekend cohort exhibited higher odds of cardiogenic shock [aOR: 1.17; 95% CI: 1.14-1.21, p < 0.001], intra-aortic balloon pump use [aOR: 1.11; 95% CI: 1.07-1.15, p < 0.001], acute respiratory failure [aOR: 1.15; 95% CI: 1.09-1.22, p < 0.001], acute ischemic stroke [aOR: 1.09; 95% CI: 1.02-1.16, p = 0.008], and acute kidney injury [aOR: 1.13; 95% CI: 1.11-1.15, p < 0.001]. However, admission for PCI during the weekend led to lower vascular complications [aOR: 0.77; 95% CI: 0.72-0.82, p < 0.001], post-operative bleeding [aOR: 0.90; 95% CI: 0.87-0.94, p < 0.001], and blood transfusion [aOR: 0.93; 95% CI: 0.89-0.97, p = 0.003]. This study suggests that admission during the weekend for PCI may pose a hazard with worse outcomes and higher in-hospital mortality compared to weekday admission.