The Weekend Effect on Outcomes in Patients Presenting With Acute Aortic Dissection: A Nationwide Analysis

Altujjar, Mohammad; Mhanna, Mohammed; Bhuta, Sapan; Patel, Neha; Miedema, Michael D.; Manunga, Jesse; Hennessey, Kerrilynn; Henkin, Stanislav; Andrus, Bruce Wayne; Taub, Cynthia C.; Creager, Mark A.; Harris, Kevin M.

doi:10.1016/s0735-1097(22)02733-4

Cited by 3 publications

(6 citation statements)

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“…The findings for open repair in TBAD align with those observed in previous studies on TAAD, where no differences were found in postoperative mortality rates between patients admitted during weekdays and those admitted over the weekend. 18,19 Additionally, for TAAD, patients admitted over the weekend did not experience a longer time until operation, a finding consistent with TBAD open repair cases where no delays were reported in this study. 19 Given that TAAD often manifests as an emergency requiring immediate open surgical intervention, the similar results across these 2 types of aortic dissection support the assertion that the weekend effect is less prominent in urgent, complex cases of aortic surgery.…”

Section: Discussionsupporting

confidence: 83%

“…18,19 Additionally, for TAAD, patients admitted over the weekend did not experience a longer time until operation, a finding consistent with TBAD open repair cases where no delays were reported in this study. 19 Given that TAAD often manifests as an emergency requiring immediate open surgical intervention, the similar results across these 2 types of aortic dissection support the assertion that the weekend effect is less prominent in urgent, complex cases of aortic surgery.…”

Section: Discussionsupporting

confidence: 83%

“…Regarding the weekend effect on surgical complications in TBAD, earlier research mainly concentrated on mortality rates. 19 In the study by Altujjar et al, researchers found that weekend admissions of TBAD patients correlated with elevated mortality rates. However, their study did not differentiate between open and TEVAR approaches for TBAD repair.…”

Section: Discussionmentioning

confidence: 98%

“…While many studies have investigated the weekend effect on mortality rates for TAAD, the impact of this phenomenon on TBAD remains less studied. [18][19][20] In one study that examined the weekend effect in TBAD, it was discovered that weekend admission of TBAD patients is linked to increased mortality rates. 19 As TBAD treatment modalities, such as open repair and TEVAR, involve different patient selection criteria and management strategies, it is critical to consider these surgical approaches separately when analyzing the impact of weekend admission on outcomes after TBAD repair.…”

Section: Introductionmentioning

confidence: 99%

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Weekend Admission is Associated with Higher Kidney Failures after Thoracic Endovascular Aneurysm Repair for Stanford Type B Aortic Dissection

Li,

Luo,

Green

et al. 2023

Vasc Endovascular Surg

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Background Weekend effect characterized by worse perioperative outcomes has been demonstrated in some surgery patients admitted on weekends, as opposed to weekdays. This study aimed to examine weekend effect on open surgical repair or thoracic endovascular aneurysm repair (TEVAR) for Stanford Type B Aortic Dissection (TBAD). Methods Patients who underwent TBAD repair were identified in National/Nationwisde Inpatient Sample from Q4 2015-2020. Open surgery and TEVAR were examined separately. Multivariable analyses were performed comparing in-hospital perioperative outcomes of patients under weekday and weekend admission. Adjusted preoperative variables included sex, age, race, socioeconomic status, hospital characteristics, clinical symptoms, comorbidities, and elective/non-elective admission. Also, length of stay, days from admission to operation, and total hospital charge were compared. Results Among patients who underwent open TBAD repair, 1321 were admitted on weekdays and 340 on weekends. Among patients who underwent TEVAR for TBAD, 2018 were admitted on weekdays and 440 wereadmitted on weekends. There was no difference in open repair outcomes between those admitted on weekdays vs weekends. In TEVAR, weekend admission was associated with higher post-procedural kidney failure (1.14% vs .20%, aOR = 4.11, P = .04) and superficial wound complications (2.73% vs 1.49%, aOR = 2.2, P = .03) but lower respiratory complications (5.80% vs 3.64%, aOR = .47, P = .01). Also, in TEVAR, weekend admission was associated with longer time from admission to operation (3.92 ± .27 vs 2.35 ± .09 days, P < .01). Conclusions Renal malperfusion was a common indication for TBAD repair. TBAD patients admitted over the weekend and underwent TEVAR had higher post-procedural kidney failure, which may be due to delayed diagnosis and treatment.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Weekend Admission is Associated with Higher Kidney Failures after Thoracic Endovascular Aneurysm Repair for Stanford Type B Aortic Dissection

Li,

Luo,

Green

et al. 2023

Vasc Endovascular Surg

View full text Add to dashboard Cite

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“…In particular, the occurrence of preoperative and postoperative events must be taken into account when analyzing mortality and its reduction in relation to inpatient and outpatient care. To identify and manage risk factors and circumstances that could influence a hospitalized patient's mortality, this evaluation is required [33][34][35][36]. Due to the high rate of death associated with this disease, the treatment approach in the case of an emergency presentation of a patient with an aortic dissection must be concentrated on the segments that are eligible for therapeutic intervention.…”

Section: Discussionmentioning

confidence: 99%

Prospective Evaluation of the Weekend Effect on Mortality Outcomes in Aortic Dissection

Cosmin¹,

Harpa²,

Brînzaniuc³

et al. 2023

Preprint

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Aortic dissection (AD) is a critical heart condition with potentially severe outcomes. Our study aims to investigate the existence of a "weekend effect" in AD by examining the correlation between patient outcomes and the timing of their treatment during weekdays vs weekends. Specifically, we assessed prospectively the effects of the timing of treatment on patient outcomes for acute aortic dissection, both before surgical intervention and during hospitalization, as well as during the follow-up period. The mean age of the study population used here was 62.5 years with a high degree of variability. We recorded a rate of mortality before surgery of 8.65% for the weekend group and 15% for the weekday group, with no significant differences noted in the results of statistical tests. During hospitalization, mortality was found to be 50% (n=52) in the weekend group and 25% (n=5) in the weekday group, again with no significant differences observed in the results of the same statistical tests. Patient mortality after discharge was 9.61% (n=10) in the weekend group and 5% (n=1) in the weekday group. Our findings suggest that there is no significant difference in mortality rates between patients admitted to the hospital on weekends versus weekdays. Therefore, the period of the week when a patient presents to the hospital with aortic dissection appears to not affect their mortality outcomes.

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Weekend Effect and Mortality Outcomes in Aortic Dissection: A Prospective Analysis

Banceu,

Harpa,

Brinzaniuc

et al. 2024

The Journal of Critical Care Medicine

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Background Aortic dissection (AD) is a critical heart condition with potentially severe outcomes. Our study aimed to investigate the existence of a “weekend effect” in AD by examining the correlation between patient outcomes and whether their treatment occurred on weekdays versus weekends. Methods Specifically, we prospectively analysed the effect of weekday and weekend treatment on acute AD patient outcomes, both before surgical intervention and during hospitalization, for 124 patients treated from 2019–2021, as well as during 6 months of follow-up. Results The mean age of the study population was 62.5 years, and patient age exhibited a high degree of variability. We recorded a mortality rate before surgery of 8.65% for the weekend group and 15% for the weekday group, but this difference was not statistically significant. During hospitalization, mortality was 50% in the weekend group and 25% in the weekday group, but this difference was not statistically significant. Discharge mortality was 9.61% in the weekend group and 5% in the weekday group. Conclusions Our findings suggest that there was no significant difference in mortality rates between patients admitted to the hospital on weekends versus weekdays. Therefore, the period of the week when a patient presents to the hospital with AD appears not to affect their mortality.

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The Weekend Effect on Outcomes in Patients Presenting With Acute Aortic Dissection: A Nationwide Analysis

Cited by 3 publications

References 0 publications

Weekend Admission is Associated with Higher Kidney Failures after Thoracic Endovascular Aneurysm Repair for Stanford Type B Aortic Dissection

Weekend Admission is Associated with Higher Kidney Failures after Thoracic Endovascular Aneurysm Repair for Stanford Type B Aortic Dissection

Prospective Evaluation of the Weekend Effect on Mortality Outcomes in Aortic Dissection

Weekend Effect and Mortality Outcomes in Aortic Dissection: A Prospective Analysis

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