Author + information
- Jonathan Hsu,
- Paul Varosy,
- Craig S. Parzynski,
- Sarwat Chaudhry,
- Thomas Dewland,
- Jeptha Curtis and
- Gregory Marcus
Procedures performed later in the day and on weekends may result in more adverse events due to a variety of factors including operator fatigue, handoffs, reduced staffing, and limited resource availability. We assessed whether patients implanted with ICDs in the afternoon/evening and on weekends/holidays were at increased risk for adverse events and mortality.
We studied 148,004 first-time ICD recipients in the ICD Registry™ implanted between April, 2010 and March, 2012. Using hierarchical multivariable logistic regression adjusting for patient, implanting physician, and hospital characteristics, we examined the association between both procedural start time and day of week with any complication, length of hospital stay, and mortality.
The majority of ICD implants (52.6%, n=77,853) were performed in the morning (6AM-12PM) and during the regular workweek (97.5%, n=144,266). After multivariable adjustment, ICD recipients implanted in the afternoon (12PM-5PM) and evening (5PM-6AM) compared to the morning or during the weekend/holidays compared to weekdays experienced a greater odds of any complication, hospital stay >1 day, and inhospital death (Figure).
In a large, real-world population, ICD recipients implanted in the afternoon/evening or on weekends/holidays experienced significantly more procedural complications, prolonged hospital stays, and death.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Improving Heart Failure Outcomes II
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1200-105
- 2013 American College of Cardiology Foundation