Impact of day of admission on patients admitted with complete heart block: Analyzing the weekend effect.

Background: Complete heart block (CHB) is a conduction disorder that can be fatal if not treated promptly. Admission on a week or weekend day may influence the outcomes of cardiac emergencies, such as CHB.

Objectives: The purpose of this study was to determine the effects of weekday vs. weekend admissions in terms of CHB outcomes.

Methods: A retrospective cohort study was conducted using the National Inpatient Sample database to study the outcomes of adult patients admitted with complete heart block. Outcomes were compared between the patients admitted on weekends (midnight Friday to midnight Sunday) and weekdays.

Results: Thirty-four thousand three hundred ninety-five patients were included, of which 7350 (21.37 %) were admitted on weekends. Mean age for included patients was 75.69 years, with 43.23 % females. Compared to those admitted on weekdays, participants admitted on weekends had similar mortality (aOR 0.73; 95 % CI 0.46-1.16), longer length of stay (mean increase 0.74 days; P < 0.01) and higher hospital charges (mean increase $10,540.82; P < 0.01). Weekend admissions were associated with higher rates of cardiac arrest (adjusted OR 1.40; 95 % CI 1.07-1.84; P = 0.02) and higher rates of cardiogenic shock (adjusted OR 1.40; 95 % CI 1.07-1.83; P = 0.01) and similar rates of permanent pacemaker implantation (adjusted OR 0.88; 95 % CI 0.77-1.01; P = 0.06), but had longer delay to permanent pacemaker (mean increase 0.46 days; P < 0.01).

Conclusion: Hospital and administrative-level strategies are needed to address the differences between the weekend and weekday CHB admissions.