Mamas Mamas m.mamas@keele.ac.uk
Weekend effect in acute coronary syndrome: A meta-analysis of observational studies.
Mamas
Authors
Abstract
BACKGROUND:
The effect of a weekend compared with a weekday hospital admission on patient outcomes after an acute coronary syndrome is unclear. This study aims to determine whether collectively there is a weekend effect in acute coronary syndrome.
METHOD:
We conducted a systematic review and meta-analysis of cohort studies examining the association between weekend compared to weekday admission at any time of the day and early mortality (in-hospital or 30-day). A search was performed on Medline and Embase and relevant studies were pooled using random effects meta-analysis for risk of early mortality. Additional analyses were performed considering only more recent studies (conducted after 2005) and by patient group (ST-elevation myocardial infarction [STEMI] or non-STEMI [NSTEMI]), as well as meta-regression according to starting year and mean year of study.
RESULTS:
A total of 18 studies were included with over 14 million participants incorporating 3 million weekend and over 11.5 million weekday admissions and the rates of mortality were 19.2% and 23.4%, respectively. The pooled results of all 18 studies suggest that weekend admission was associated with a small increased risk of early mortality (odds ratio [OR] 1.06, 95% confidence interval [CI] 1.03-1.09). The results for subgroups of STEMI and NSTEMI cohorts were not statistically significant and timing of admission after 2005 had minimal influence on the results (OR 1.06, 95% CI 0.95-1.17).
CONCLUSIONS:
There is a small weekend effect for admission with acute coronary syndrome that has persisted over time.
Acceptance Date | Mar 2, 2018 |
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Publication Date | Aug 1, 2019 |
Publicly Available Date | Mar 29, 2024 |
Journal | European Heart Journal: Acute Cardiovascular Care |
Print ISSN | 2048-8726 |
Publisher | SAGE Publications |
Pages | 432-442 |
DOI | https://doi.org/10.1177/2048872618762634 |
Keywords | acute coronary syndrome; weekend; mortality; meta-analysis |
Publisher URL | http://journals.sagepub.com/doi/10.1177/2048872618762634 |
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Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/
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