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'Weekend' effect may impact PCI outcomes

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NEW ORLEANS — In a study comparing hospital admissions for percutaneous coronary intervention on a weekend or weekday, patients who underwent procedures over the weekend had a higher rate of in-hospital mortality, longer hospital stay and increased cost of care.

“There is controversy about what is known as ‘the weekend effect,” according to Byomesh Tripathi, MD, resident physician at Mount Sinai St. Luke’s and Mount Sinai West Hospital.

However, the researchers noted that “margins are closing” between weekend and weekday admissions for PCI. Tripathi and colleagues “speculate that better access to care on weekends could improve the outcome for patients undergoing PCI.”

The current study, presented as an abstract at the Society for Cardiovascular Angiography and Interventions Annual Meeting, focused on 2004-2013 data from the Nationwide Inpatient Sample. The large cohort included 1,293,209 patients who underwent PCI during the study period. Two-thirds were men and 88% were aged 50 years and older.

Weekend admissions for PCI increased from 12.4% in 2004 to 21.5% in 2013, for a relative change of 82.4%.

The rate of in-hospital mortality was higher among patients admitted on the weekend compared with on a weekday: 2.1% vs. 1.2% (P < .001).  

Weekend admission was also associated with longer hospital stay. On average, patients admitted for PCI on a weekend had an average length of stay of 4.2 days compared with 2.9 days for those admitted on a weekday (P < .001).

An effect on cost of care was also observed in this large sample. The average cost of care for a weekend PCI admission was $23,630 compared with $20,080 for a weekday PCI admission (P < .001).

The data did, however, signal a decline in duration of hospitalization by –11.8% and cost of care by –6.22% during the study period (P < .001 for both). – by Katie Kalvaitis

Reference:

Kumar V, et al. Abstract C-081. Presented at: Society for Cardiovascular Angiography and Interventions Annual Meeting; May 10-13, 2017; New Orleans.

Disclosure: Tripathi reports no relevant financial disclosures.