The "weekend effect" in patients admitted with heart failure - an important gap in care?

The “weekend effect” has been described in patients admitted for various urgent medical conditions. 1 Bell CM Redelmeier DA Mortality among patients admitted to hospitals on weekends as compared with weekdays. N Engl J Med. 2001; 345: 663-668https://doi.org/10.1056/NEJMsa003376 Crossref PubMed Scopus (887) Google Scholar Patients admitted on weekends are generally reported to have worse outcomes, although this is not always the case. 1 Bell CM Redelmeier DA Mortality among patients admitted to hospitals on weekends as compared with weekdays. N Engl J Med. 2001; 345: 663-668https://doi.org/10.1056/NEJMsa003376 Crossref PubMed Scopus (887) Google Scholar Some studies have found that patients admitted on weekends had more comorbidities and were, therefore, more predisposed to adverse outcomes. 2 Bressman E Rowland JC Nguyen V-T Raucher BG Severity of illness and the weekend mortality effect: a retrospective cohort study. BMC Health Serv Res. 2020; 20: 169https://doi.org/10.1186/s12913-020-5029-6 Crossref PubMed Scopus (2) Google Scholar However, other studies have not found a difference in patients’ characteristics in those admitted on weekends. 1 Bell CM Redelmeier DA Mortality among patients admitted to hospitals on weekends as compared with weekdays. N Engl J Med. 2001; 345: 663-668https://doi.org/10.1056/NEJMsa003376 Crossref PubMed Scopus (887) Google Scholar In a previous study, weekend admissions due to heart failure (HF) were associated with increased in-hospital mortality rates (adjusted OR 2.37, 95%CI 1.93–2.91), but mortality rates at 28 days were similar between weekend- and weekday-admission groups. 3 Mounsey LA Chang PP Sueta CA Matsushita K Russell SD Caughey MC In-hospital and postdischarge mortality among patients with acute decompensated heart failure hospitalizations ending on the weekend versus weekday: the ARIC Study Community Surveillance. J Am Heart Assoc. 2019; 8e011631https://doi.org/10.1161/JAHA.118.011631 Crossref PubMed Scopus (12) Google Scholar Comparison of 30-day Readmission Rates and Inpatient Cardiac Procedures for Weekday Versus Weekend Hospital Admissions for Heart FailureJournal of Cardiac FailureVol. 29Issue 10PreviewWhether the timing of hospital presentation impacts care delivery and clinical outcomes for patients hospitalized for heart failure (HF) remains a matter of debate. In this study, we examined all-cause and HF-specific 30-day readmission rates for patients who were admitted for HF on a weekend vs admitted for HF on a weekday. Full-Text PDF