Exploring the “Weekend Effect” on the Care of Patients with Left Ventricular Assist Devices

Background Many studies have described differences in in-hospital outcomes and length of stay between patients treated for major cardiac conditions on weekdays versus weekends.1 Our study aimed to explore the “weekend effect” on in-hospital care among patients with left ventricular assist devices. Methods Using data from the National Inpatient Sample (NIS) database, with a weighted estimate of more than 35 million admissions per year.2 We identified patients 18 years or older with an ICD code signifying presence of a LVAD. Characteristics, comorbidities and clinical outcomes were compared between patients admitted on a weekend versus patients admitted on a weekday. The outcomes of interest were in-hospital all-cause mortality and length of hospital stay (LOS). Results Patients admitted on weekend days were younger, otherwise both groups were similar with respect to comorbidities. Patients admitted on weekend days were more likely to have cardiogenic shock, septic shock and respiratory failure. They were also more likely to require mechanical ventilation and undergo cardiac transplantation. Patients admitted on a weekend day however had a shorter hospital median hospital stay. This remained significant after multivariate analysis (OR .81 95% CI .72-.91, p<0.01). Our data analysis from this large database demonstrates no effect of weekend admission on all-cause mortality among patients with LVADs, although patients admitted on weekend days were more likely to have shorter hospital stay.