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Acute coronary syndrome requires urgent diagnostic and therapeutic procedures, which may not be uniformly available throughout the week. So, we sought to examine the effects of admission on clinical outcomes in patients with wide spectrum coronary artery diseases.
A retrospective analysis of ICCU Inpatient sample database of 17 months from 2015 to 2016 used to compare differences in in-hospital mortality between patients admitted on a non-weekday versus weekend for wide spectrum ACS which include STEMI, NSTEMI and unstable angina and patients with cardiogenic shock. Out of these 75% had higher TIMI risk score (5-7).
Total 2700 patients with ACS were included in the present study with wide spectrum coronary artery diseases. Out of those 20% (n=541) were admitted on weekends and 79.9% (n=2159) were admitted in non-weekends. The mean age of patients on non-weekend were 58.7 ± 14.6 years, when compared to that on weekend it was 57.4 ± 8.1 years with statistically significant difference (p=0.004). Of these females had a mean age of 61.1 ± 12 years for non-weekend and 58.5 ± 13.3 years for weekend admissions which were comparable with the mean age of males 57.7 ± 15.55 years for non-weekend and 56.9 ± 13.1 years weekend admissions. The in-hospital mortality rate of these patients admitted on non-weekends was 9.4% (n=204) and those admitted on weekends was 5.9% (n=32) with statistically significant difference (95% CI; p= 0.003).
Our study shows that there is no added mortality in patients with coronary artery disease on weekend days compared with non-weekend days. As the patients admitted during non-weekend were elder and sicker than the weekend admissions (having the high-risk score), the in-hospital mortality is higher on non-weekends. Efforts to improve health care system should ensure comparable outcomes for patients irrespective to the time of hospital admission.