Key result
Weekend presentation for aortic dissection was associated with higher in-hospital mortality compared with weekday presentation (11.8% vs 10.4%; OR 1.17, 95% CI 1.05-1.29, P=0.003).
Why the study?
This study evaluated 10-year trends in aortic dissection mortality from 2006 to 2017 and assessed the impact of weekday versus weekend presentation on mortality.
Does weekend presentation increase in-hospital mortality in patients with aortic dissection compared to weekday presentation?
Observational (n=36,399)
Yes
Does weekend presentation increase in-hospital mortality in patients with aortic dissection compared to weekday presentation?
Despite a general decrease in aortic dissection mortality over time, patients presenting on weekends face a significantly higher risk of in-hospital mortality compared to those presenting on weekdays.
Answers are grounded in this paper and cite their sources.
Supports attention to weekend aortic dissection management; leaves open whether the association is causal.
BACKGROUND: This study examined changes in aortic dissection (AD) mortality from 2006 to 2017 and assessed the impact of weekday versus weekend presentation upon mortality. METHODS: This observational study analyzed all records in the Nationwide Emergency Department Sample (NEDS) database. NEDS aggregates discharge data from 984 hospitals in 36 states and the District of Columbia in the United States of America. All patients with thoracic and thoracoabdominal AD recorded as their principal diagnosis were identified via ICD codes. RESULTS: Patient characteristics (weekday|weekend) count: 26,759|9,640, P = 0.016; age (years): 65.2 ± 15.8|64.7 ± 16.2, P = 0.016; women: 11,318 (42.3%)|4,086 (42.4), P = 0.883; Charlson comorbidity index: 2.3 ± 1.7|2.3 ± 1.6, P = 0.025. There were 36,399 ED visits with diagnosed AD. Annual AD diagnoses increased by 70% from 2006 to 2017. From 2012-2017, patients had lower in-hospital mortality (9.9% versus 11.9%, P < 0.001) compared with 2006-2011. Patients reporting during the weekend had higher in-hospital mortality (11.8% versus 10.4%, P < 0.001) compared with weekdays. On multivariable analysis, year of presentation remained independently associated with in-hospital mortality, with 2012-2017 being associated with reduced mortality (odds ratio (OR) 0.90, 95% CI: 0.82, 0.99, P = 0.031), as compared with 2006-2011. Weekend presentation remained independently associated with worse in-hospital mortality (OR 1.17, 95% CI: 1.05, 1.29, P = 0.003) compared with weekday presentation. CONCLUSION: Although AD mortality is decreasing, the patients presenting on the weekend were 13% more likely to die in the hospital compared with patients presenting during the week.
No takes yet. Share an insight, caveat, or question.
Brown et al. (2021) conducted an observational in Aortic dissection (n=36,399). Weekend presentation vs. Weekday presentation was evaluated on In-hospital mortality (OR 1.17, 95% CI 1.05, 1.29, p=0.003). Weekend presentation for aortic dissection was associated with higher in-hospital mortality compared with weekday presentation (11.8% vs 10.4%; OR 1.17, 95% CI 1.05-1.29, P=0.003).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: