Comparison of Case Fatality Rates for Acute Myocardial Infarction in Weekday vs Weekend Admissions in South Korea

Abstract

Background: According to recent reports, reduced weekend staffing in hospitals may lead to a lower intensity of management of patients with acute conditions such as acute myocardial infarction (AMI). The present study evaluated differences in the case fatality rate of Korean patients admitted with AMI on weekdays vs those admitted on weekends. Methods and Results:The dataset was constructed from the Korea National Health Insurance Claims Database. The study population was 97,466 patients who were admitted to a hospital in Korea from 2003 to 2007 with AMI. Patients admitted on weekends had a higher 30-day fatality rate (20.1% vs 17.3%) than did those admitted on weekdays. Differences in the 30-day fatality rate were significant after adjusting for baseline characteristics and the severity of disease (odds ratio (OR), 1.21; 95% confidence interval (CI), 1.16-1.26). However, the 30-day fatality rate was insignificantly different after additional adjustment for medical or invasive management (OR 1.05; 95%CI 0.99-1.11).Conclusions: Differences in the case fatality rate of AMI patients admitted on weekdays and on weekends in Korea are caused by differences in the rate of performance of medical or invasive procedures. (Circ J 2010; 74: 496 - 502)

Survival After Extracorporeal Cardiopulmonary Resuscitation on Weekends in Comparison With Weekdays

“…Patients admitted on the weekend were less likely to undergo invasive cardiac procedures compared with patients admitted on weekdays, and a longer time from admission to procedures was also reported [10]. Similarly, Peberdy and colleagues [9] found that survival rates after in-hospital cardiac arrest are lower during the weekend.…”

“…Hospital resources may be different on weekdays compared with weekends, and the survival rates on weekends in cases of heart attack, stroke, and trauma are worse [6,7,9,10,[12][13][14]. The disparity in patient outcomes, the so-called weekend effect, has been well documented in a large number of previous studies of critical situations [6,7,9,10,13]. However, the weekend effect on ECPR has not been studied.…”

“…In general, hospital resources may be limited in quantity and quality on the weekend [5,6]. This weekend effect on patients' outcomes has been well documented for time-sensitive conditions such as heart attack, stroke, and severe trauma [6][7][8][9][10]. However, few data exist about the outcomes of patients with cardiac arrest who receive in-hospital ECPR on the weekday compared with the weekend.…”

Effect of weekend admission for acute myocardial infarction on in-hospital mortality: A retrospective cohort study

“…The effect of off-hour admission for AMI on mortality has been controversial because previous studies have shown inconsistent results [1,[3][4][5][9][10][11][12][13][14][15]. Recently, a study using data from an administrative database in New Jersey reported that 30-day mortality for AMI was higher in patients admitted on weekends than on weekdays [10].…”

Procedure utilization, latency and mortality: Weekend versus Weekday admission for Myocardial Infarction

“…Whether or not staf ing patterns dictate this interval, and what effect that may have on patient outcomes, is unclear. There have been a few reports that compare mortality rates among MI admitted on weekends compared to those admitted on weekdays, however, the indings have been inconsistent [6][7][8][9][10]. This has, in part, been due to difference in statistical adjustment, population size and proportion of PCI capable hospitals.…”