Weekend effects of admission and surgery in acute aortic syndrome

Background: The weekend effect is a phenomenon characterized by increased early all-cause mortality among patients hospitalized or undergoing surgery over the weekend for emergencies. Objectives: With this meta-analysis we aimed to determine whether weekend hospitalization/surgery due to acute aortic syndromes (AAS) is associated with increased early all-cause mortality. Methods：Major electronic databases were searched for studies published up to October 2020 reporting early all-cause mortality rates for admissions/operations on weekends versus weekdays. Data were pooled using fixed- and random-effects models. The primary outcome of the study was early all-cause mortality after weekend versus weekday. Results: All the included studies were retrospective, comparative or cohort studies enrolling patients admitted or underwent surgery for AAS and reported early all-cause mortality after weekend (including holiday) versus weekday. A total of 18 studies including a total of 252807 patients were identified. This meta-analysis showed a significant increase in the early all-cause mortality for patients admitted/conducted surgery for AAS on weekends compare with weekdays (fixed-effect: OR 1.1;95% CI 1.06-1.14;P＜0.00001). Conclusion: Weekend admission/surgery for AAS is associated with a increased risk of early all-cause mortality.