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Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study
BACKGROUND: Patients admitted on weekends have higher mortality than those admitted on weekdays. However, whether the “weekend effect” results in a higher mortality after admission for acute aortic dissection (AAD),—classified according to Stanford types—remains unclear. This study aimed to examine...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601417/ https://www.ncbi.nlm.nih.gov/pubmed/34793535 http://dx.doi.org/10.1371/journal.pone.0260152 |
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author | Kato, Katsuhito Otsuka, Toshiaki Nakai, Michikazu Sumita, Yoko Seino, Yoshihiko Kawada, Tomoyuki |
author_facet | Kato, Katsuhito Otsuka, Toshiaki Nakai, Michikazu Sumita, Yoko Seino, Yoshihiko Kawada, Tomoyuki |
author_sort | Kato, Katsuhito |
collection | PubMed |
description | BACKGROUND: Patients admitted on weekends have higher mortality than those admitted on weekdays. However, whether the “weekend effect” results in a higher mortality after admission for acute aortic dissection (AAD),—classified according to Stanford types—remains unclear. This study aimed to examine the association between admission day and in-hospital mortality in AAD Type A and B. METHODS: We used data from the Japanese registry of all Cardiac and Vascular Diseases Diagnostic Procedure Combination, a nationwide claim-based database with data from 953 certified hospitals, and enrolled in-patients with AAD admitted between April 1, 2012, and March 31, 2016. Based on the admission day, we stratified patients into groups (Weekdays, Saturdays, and Sundays/holidays). The influence of the admission day on in-hospital mortality was assessed via multi-level logistic regression analysis. We also performed a Stanford type-based stratified analysis. RESULTS: Among the included 25,641 patients, in-hospital mortality was 16.0%. The prevalence of patients admitted with AAD was relatively higher on weekdays. After adjustment for covariates, patients admitted on a Sunday/holiday showed an increased risk of in-hospital mortality (odds ratio [OR] 1.20; 95% confidence interval [CI] 1.07–1.33, p<0.001) than patients admitted on weekdays. Among patients admitted on a Sunday/holiday, only the subgroup of Stanford Type A showed a significantly increased risk of in-hospital mortality. (Stanford Type A, non-surgery vs. surgery groups: 95% CI 1.06–1.48 vs. 1.17–1.68, p<0.001 for both groups, OR 1.25 vs. 1.41, respectively, Stanford Type B, non-surgery vs. surgery groups: 95% CI 0.64–1.09 vs. 0.40–2.10; p = 0.182 vs. 0.846; OR 0.84 vs. 0.92). CONCLUSIONS: In conclusion, patients with AAD Type A admitted on a Sunday/holiday may have an increased in-hospital mortality risk. |
format | Online Article Text |
id | pubmed-8601417 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-86014172021-11-19 Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study Kato, Katsuhito Otsuka, Toshiaki Nakai, Michikazu Sumita, Yoko Seino, Yoshihiko Kawada, Tomoyuki PLoS One Research Article BACKGROUND: Patients admitted on weekends have higher mortality than those admitted on weekdays. However, whether the “weekend effect” results in a higher mortality after admission for acute aortic dissection (AAD),—classified according to Stanford types—remains unclear. This study aimed to examine the association between admission day and in-hospital mortality in AAD Type A and B. METHODS: We used data from the Japanese registry of all Cardiac and Vascular Diseases Diagnostic Procedure Combination, a nationwide claim-based database with data from 953 certified hospitals, and enrolled in-patients with AAD admitted between April 1, 2012, and March 31, 2016. Based on the admission day, we stratified patients into groups (Weekdays, Saturdays, and Sundays/holidays). The influence of the admission day on in-hospital mortality was assessed via multi-level logistic regression analysis. We also performed a Stanford type-based stratified analysis. RESULTS: Among the included 25,641 patients, in-hospital mortality was 16.0%. The prevalence of patients admitted with AAD was relatively higher on weekdays. After adjustment for covariates, patients admitted on a Sunday/holiday showed an increased risk of in-hospital mortality (odds ratio [OR] 1.20; 95% confidence interval [CI] 1.07–1.33, p<0.001) than patients admitted on weekdays. Among patients admitted on a Sunday/holiday, only the subgroup of Stanford Type A showed a significantly increased risk of in-hospital mortality. (Stanford Type A, non-surgery vs. surgery groups: 95% CI 1.06–1.48 vs. 1.17–1.68, p<0.001 for both groups, OR 1.25 vs. 1.41, respectively, Stanford Type B, non-surgery vs. surgery groups: 95% CI 0.64–1.09 vs. 0.40–2.10; p = 0.182 vs. 0.846; OR 0.84 vs. 0.92). CONCLUSIONS: In conclusion, patients with AAD Type A admitted on a Sunday/holiday may have an increased in-hospital mortality risk. Public Library of Science 2021-11-18 /pmc/articles/PMC8601417/ /pubmed/34793535 http://dx.doi.org/10.1371/journal.pone.0260152 Text en © 2021 Kato et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kato, Katsuhito Otsuka, Toshiaki Nakai, Michikazu Sumita, Yoko Seino, Yoshihiko Kawada, Tomoyuki Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study |
title | Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study |
title_full | Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study |
title_fullStr | Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study |
title_full_unstemmed | Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study |
title_short | Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study |
title_sort | effect of holiday admission for acute aortic dissection on in-hospital mortality in japan: a nationwide study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601417/ https://www.ncbi.nlm.nih.gov/pubmed/34793535 http://dx.doi.org/10.1371/journal.pone.0260152 |
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