Comparison of Outcomes for Non-ST Elevation Acute Myocardial Infarction in Weekday vs Weekend Admissions: The Weekend Effect

Ali R Ghani; Wajahat Humayun; Waqas Ullah; Mohsin S Mughal; Irfan Ahsan; Asoka Balaratna; Ammar Nasir

doi:10.55729/2000-9666.1028

Comparison of Outcomes for Non-ST Elevation Acute Myocardial Infarction in Weekday vs Weekend Admissions: The Weekend Effect

J Community Hosp Intern Med Perspect. 2022 Apr 12;12(2):6-9. doi: 10.55729/2000-9666.1028. eCollection 2022.

Authors

Ali R Ghani¹, Wajahat Humayun², Waqas Ullah², Mohsin S Mughal³, Irfan Ahsan⁴, Asoka Balaratna⁵, Ammar Nasir¹

Affiliations

¹ Saint Louis University Hospital, MO, USA.
² Thomas Jefferson University Hospitals, PA, USA.
³ Rutgers/Monmouth Medical Center, New Jersey, USA.
⁴ Geisinger Medical Center, PA, USA.
⁵ Abington Jefferson Health, PA, USA.

Abstract

Background: Recent literature shows that reduced staffing over the weekends in hospitals may compromise patient care with acute conditions like acute coronary syndrome (ACS).

Objective: Our study evaluated differences in the outcomes between patients presenting with non-ST segment elevation acute coronary syndrome (NSTE-ACS) on weekends versus those coming on weekdays.

Methods: A single-center retrospective study was performed on NSTE-ACS patients. Data were analyzed using SPSS version 22 to calculate an independent sample t-test value for significance between the two groups.

Results: The mean DTB time for patients admitted over the weekend was significantly higher than those admitted over weekdays (p = 0.000). The mean peak troponin level and length of stay (LOS) for patients admitted over the weekends vs. weekdays was significantly higher by 5 ng/dL (9.71 ± 5.23 vs. 4.194 ± 2.60, p = 0.0001) and 24 h (72 ± 10 vs. 48 ± 6 h, p = 0.003), respectively. While the mean left ventricular ejection fraction (EF) of patients on discharge was lower by 5% for patients admitted over the weekend compared to patients admitted on weekdays (p = 0.001).

Conclusion: NSTE-ACS patients admitted over the weekends have a significantly higher myocardial injury evidenced by an increased LOS, higher peak troponin levels, and reduced EF due to delayed PCI compared to weekday admissions.

Keywords: Acute coronary syndrome (ACS); Door to balloon time (DTB); Ejection fraction (EF); NSTE-ACS (Non-ST segment Elevation acute coronary syndrome); STEMI (ST-Segment elevation myocardial infarction).