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Comparison of Outcomes of Weekend Versus Weekday Admissions for Atrial Fibrillation
Study Questions:
Do patients with atrial fibrillation (AF) have worse outcomes when admitted to the hospital on a weekend day compared to a weekday?
Methods:
A national database of hospital admissions was accessed to identify 86,497 patients (mean age 70 years) with a primary diagnosis of AF. The main outcomes of the study were the use of transthoracic cardioversion, length of stay (LOS), hospital mortality, and total hospitalization charges for patients admitted on a weekday versus a weekend day.
Results:
There were 69,548 admissions on a weekday and 16,949 on a weekend day. Hospital mortality was significantly lower for the weekday admissions (0.9%) than for the weekend admissions (1.1%). After adjusting for several confounding variables, weekend admissions were associated with a 24% higher hospital mortality rate. Cardioversion was more than twice as likely to be performed for weekday admissions (16.2%) than for weekend admissions (7.9%). The mean LOS was approximately 3.5 days in both groups. Hospital charges were a mean of $4,000 less for the weekend admissions than for the weekday admissions.
Conclusions:
Patients with AF who are admitted to the hospital on weekends less often are treated with cardioversion, and have a higher mortality rate than patients with AF admitted on weekdays.
Perspective:
Because AF is not a fatal arrhythmia, the reason that mortality is higher for weekend admissions than for weekday admissions is unclear. A possible explanation is that weekend admissions are less likely to be elective in nature and more likely to be unscheduled admissions of patients presenting to an emergency room because of acute deterioration. Such patients may be more likely to have severe comorbidities that contribute to mortality.
Keywords: Hospital Mortality, Atrial Fibrillation, Hospitalization
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