Data demonstrate "weekend effect" for AF patients

Patients with atrial fibrillation (AF) who are admitted on the weekend are less likely to receive cardioversion procedures and more likely to die than those who are admitted during the week, according to a new study published in the July 15 issue of The American Journal of Cardiology.

Abhishek Deshmukh, MD, of the University of Arkansas for Medical Sciences in Little Rock, and colleagues, examined data from the Nationwide Inpatient Sample 2008 database and identified 86,497 discharges with a primary diagnosis of atrial fibrillation. Of those, about 20% occurred between midnight on Friday and midnight on Sunday.

The researchers found that patients admitted on weekends experienced a greater proportion of in-hospital mortality than those admitted on weekdays (1.1% vs 0.9%; P= .01); they were 1.24 times more likely to die when compared with patients hospitalized on weekdays (OR=1.24; 95% CI, 1.02–1.51; P=.0029) after adjusting for patient characteristics, comorbidities, and hospital characteristics.

The investigators added that these findings may be the result of another finding in which they said patients admitted on the weekend for AF were less likely to undergo cardioversion procedures than those hospitalized on a weekday (7.9% vs 16.2%; P<.0001) and the time to cardioversion was significantly longer for patients with a weekend admission, which resulted in a longer length of stay. When cardioversion was added to the regression model, the investigators noted no significant difference in weekend and weekday mortality.

The authors noted that hospital staffing is lower during the weekend than the week and physicians who are not fully familiar with the patients are likely to provide coverage.

“Exploring methods to minimize such staffing differences and regionalization of care could potentially bridge the gap in mortality between weekend and weekday admissions observed in our study,” the authors wrote. They concluded that further research was necessary, noting that the issue should be a priority.