In‐Hospital and Postdischarge Mortality Among Patients With Acute Decompensated Heart Failure Hospitalizations Ending on the Weekend Versus Weekday: The ARIC Study Community Surveillance
Background Hospital staffing is usually reduced on weekends, potentially impacting inpatient care and postdischarge coordination of care for patients with acute decompensated heart failure (ADHF). However, investigations of in‐hospital mortality on the weekend versus weekday, and post‐hospital outco...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.011631 |
| _version_ | 1818328064585629696 |
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| author | Louisa A. Mounsey Patricia P. Chang Carla A. Sueta Kunihiro Matsushita Stuart D. Russell Melissa C. Caughey |
| author_facet | Louisa A. Mounsey Patricia P. Chang Carla A. Sueta Kunihiro Matsushita Stuart D. Russell Melissa C. Caughey |
| author_sort | Louisa A. Mounsey |
| collection | DOAJ |
| description | Background Hospital staffing is usually reduced on weekends, potentially impacting inpatient care and postdischarge coordination of care for patients with acute decompensated heart failure (ADHF). However, investigations of in‐hospital mortality on the weekend versus weekday, and post‐hospital outcomes of weekend versus weekday discharge are scarce. Methods and Results Hospitalizations for ADHF were sampled by stratified design from 4 US areas by the Community Surveillance component of the ARIC (Atherosclerosis Risk in Communities) study. ADHF was classified by a standardized computer algorithm and physician review of the medical records. Discharges or deaths on Saturday, Sunday, or national holidays were considered to occur on the “weekend.” In‐hospital mortality was compared between hospitalizations ending on a weekend versus weekday. Post‐hospital (28‐day) mortality was compared among patients discharged alive on a weekend versus weekday. From 2005 to 2014, 39 699 weighted ADHF hospitalizations were identified (19% terminating on a weekend). Demographics, comorbidities, length of stay, and guideline‐directed therapies were similar for patients with hospitalizations ending on a weekend versus weekday. In‐hospital death doubled on the weekend compared with weekday (12% versus 6%) and was not attenuated by adjustment for potential confounders (odds ratio, 2.37; 95% CI, 1.93–2.91). There was no association between weekend discharge and 28‐day mortality among patients discharged alive. Conclusions The risk of in‐hospital death among patients admitted with ADHF appears to be doubled on the weekends when hospital staffing is usually reduced. However, among patients discharged alive, hospital discharge on a weekend is not adversely associated with mortality. |
| first_indexed | 2024-12-13T12:26:13Z |
| format | Article |
| id | doaj.art-3f7711883ac04765b38a66a8dcbbdf66 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T12:26:13Z |
| publishDate | 2019-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-3f7711883ac04765b38a66a8dcbbdf662022-12-21T23:46:18ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-08-0181510.1161/JAHA.118.011631In‐Hospital and Postdischarge Mortality Among Patients With Acute Decompensated Heart Failure Hospitalizations Ending on the Weekend Versus Weekday: The ARIC Study Community SurveillanceLouisa A. Mounsey0Patricia P. Chang1Carla A. Sueta2Kunihiro Matsushita3Stuart D. Russell4Melissa C. Caughey5University of North Carolina School of Medicine Chapel Hill NCUniversity of North Carolina School of Medicine Chapel Hill NCUniversity of North Carolina School of Medicine Chapel Hill NCJohns Hopkins Bloomberg School of Public Health Baltimore MDDuke University Medical Center Durham NCUniversity of North Carolina School of Medicine Chapel Hill NCBackground Hospital staffing is usually reduced on weekends, potentially impacting inpatient care and postdischarge coordination of care for patients with acute decompensated heart failure (ADHF). However, investigations of in‐hospital mortality on the weekend versus weekday, and post‐hospital outcomes of weekend versus weekday discharge are scarce. Methods and Results Hospitalizations for ADHF were sampled by stratified design from 4 US areas by the Community Surveillance component of the ARIC (Atherosclerosis Risk in Communities) study. ADHF was classified by a standardized computer algorithm and physician review of the medical records. Discharges or deaths on Saturday, Sunday, or national holidays were considered to occur on the “weekend.” In‐hospital mortality was compared between hospitalizations ending on a weekend versus weekday. Post‐hospital (28‐day) mortality was compared among patients discharged alive on a weekend versus weekday. From 2005 to 2014, 39 699 weighted ADHF hospitalizations were identified (19% terminating on a weekend). Demographics, comorbidities, length of stay, and guideline‐directed therapies were similar for patients with hospitalizations ending on a weekend versus weekday. In‐hospital death doubled on the weekend compared with weekday (12% versus 6%) and was not attenuated by adjustment for potential confounders (odds ratio, 2.37; 95% CI, 1.93–2.91). There was no association between weekend discharge and 28‐day mortality among patients discharged alive. Conclusions The risk of in‐hospital death among patients admitted with ADHF appears to be doubled on the weekends when hospital staffing is usually reduced. However, among patients discharged alive, hospital discharge on a weekend is not adversely associated with mortality.https://www.ahajournals.org/doi/10.1161/JAHA.118.011631acute heart failuredischargeepidemiologymortality |
| spellingShingle | Louisa A. Mounsey Patricia P. Chang Carla A. Sueta Kunihiro Matsushita Stuart D. Russell Melissa C. Caughey In‐Hospital and Postdischarge Mortality Among Patients With Acute Decompensated Heart Failure Hospitalizations Ending on the Weekend Versus Weekday: The ARIC Study Community Surveillance Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute heart failure discharge epidemiology mortality |
| title | In‐Hospital and Postdischarge Mortality Among Patients With Acute Decompensated Heart Failure Hospitalizations Ending on the Weekend Versus Weekday: The ARIC Study Community Surveillance |
| title_full | In‐Hospital and Postdischarge Mortality Among Patients With Acute Decompensated Heart Failure Hospitalizations Ending on the Weekend Versus Weekday: The ARIC Study Community Surveillance |
| title_fullStr | In‐Hospital and Postdischarge Mortality Among Patients With Acute Decompensated Heart Failure Hospitalizations Ending on the Weekend Versus Weekday: The ARIC Study Community Surveillance |
| title_full_unstemmed | In‐Hospital and Postdischarge Mortality Among Patients With Acute Decompensated Heart Failure Hospitalizations Ending on the Weekend Versus Weekday: The ARIC Study Community Surveillance |
| title_short | In‐Hospital and Postdischarge Mortality Among Patients With Acute Decompensated Heart Failure Hospitalizations Ending on the Weekend Versus Weekday: The ARIC Study Community Surveillance |
| title_sort | in hospital and postdischarge mortality among patients with acute decompensated heart failure hospitalizations ending on the weekend versus weekday the aric study community surveillance |
| topic | acute heart failure discharge epidemiology mortality |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.011631 |
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