Key result
Weekend admission for peripartum cardiomyopathy is not associated with higher in-hospital mortality versus weekday admission.
Why the study?
Heart failure and cardiogenic shock have worse outcomes when admitted on weekends, but the impact of weekend admission had not been specifically evaluated in peripartum cardiomyopathy.
Does admission over the weekend worsen in-hospital outcomes in patients with peripartum cardiomyopathy?
Observational (n=6,120)
Yes
Does admission over the weekend worsen in-hospital outcomes in patients with peripartum cardiomyopathy?
Odds Ratio: 0.96 (95% CI 0.04–22.41)
p-value: p=0.978
Unlike general heart failure and cardiogenic shock, weekend admission for peripartum cardiomyopathy does not appear to be associated with worse in-hospital clinical outcomes, possibly reflecting improved care coordination.
May support equivalent in-hospital mortality regardless of admission day in peripartum cardiomyopathy; leaves open whether specialized care coordination mitigates weekend effects seen in other HF.
Background Previous studies have shown that patients with heart failure (HF) and cardiogenic shock (CS) have worse outcomes when admitted over the weekend. Since peripartum cardiomyopathy (PPCM) is a cause of CS and persisting HF, it is reasonable to extrapolate that admission over the weekend would also have deleterious effects on PPCM outcomes. However, the impact of weekend admission has not been specifically evaluated in patients with PPCM. Methods We analyzed the National Inpatient Sample (NIS) from 2016 to 2019. The International Classification of Diseases, tenth revision (ICD-10) codes were used to identify all admissions with a primary diagnosis of PPCM. The sample was divided into weekday and weekend groups. We performed a multivariate regression analysis to estimate the effect of weekend admission on specified outcomes. Results A total of 6,120 admissions met the selection criteria, and 25.3% (n=1,550) were admitted over the weekend. The mean age was 31.3 ± 6.4 years. There were no significant differences in baseline characteristics between study groups. After multivariate analysis, weekend admission for PPCM was not associated with in-hospital mortality, ventricular arrhythmias, sudden cardiac arrest, thromboembolic events, cardiovascular implantable electronic device placement, and mechanical circulatory support insertion. Conclusion In conclusion, although HF and CS have been associated with worse outcomes when admitted over the weekend, we did not find weekend admission for PPCM to be independently associated with worse clinical outcomes after multivariate analysis. These findings could reflect improvement in the coordination of care over the weekend, improvement in physician handoff, and increased utilization of shock teams.
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López et al. (2022) conducted an observational in Peripartum Cardiomyopathy (n=6,120). Weekend admission vs. Weekday admission was evaluated on All-cause in-hospital mortality (OR 0.96, 95% CI 0.04-22.41, p=0.978). Weekend admission for peripartum cardiomyopathy was not independently associated with increased all-cause in-hospital mortality compared to weekday admission (OR 0.96).
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