Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study.

<h4>Background</h4>Patients admitted on weekends have higher mortality than those admitted on weekdays. However, whether the "weekend effect" results in a higher mortality after admission for acute aortic dissection (AAD),-classified according to Stanford types-remains unclear....

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Autores principales:	Katsuhito Kato, Toshiaki Otsuka, Michikazu Nakai, Yoko Sumita, Yoshihiko Seino, Tomoyuki Kawada
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1be159331c1949c19031e140f0d7166f
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spelling	oai:doaj.org-article:1be159331c1949c19031e140f0d7166f2021-12-02T20:12:45ZEffect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study.1932-620310.1371/journal.pone.0260152https://doaj.org/article/1be159331c1949c19031e140f0d7166f2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0260152https://doaj.org/toc/1932-6203<h4>Background</h4>Patients admitted on weekends have higher mortality than those admitted on weekdays. However, whether the "weekend effect" results in a higher mortality after admission for acute aortic dissection (AAD),-classified according to Stanford types-remains unclear. This study aimed to examine the association between admission day and in-hospital mortality in AAD Type A and B.<h4>Methods</h4>We used data from the Japanese registry of all Cardiac and Vascular Diseases Diagnostic Procedure Combination, a nationwide claim-based database with data from 953 certified hospitals, and enrolled in-patients with AAD admitted between April 1, 2012, and March 31, 2016. Based on the admission day, we stratified patients into groups (Weekdays, Saturdays, and Sundays/holidays). The influence of the admission day on in-hospital mortality was assessed via multi-level logistic regression analysis. We also performed a Stanford type-based stratified analysis.<h4>Results</h4>Among the included 25,641 patients, in-hospital mortality was 16.0%. The prevalence of patients admitted with AAD was relatively higher on weekdays. After adjustment for covariates, patients admitted on a Sunday/holiday showed an increased risk of in-hospital mortality (odds ratio [OR] 1.20; 95% confidence interval [CI] 1.07-1.33, p<0.001) than patients admitted on weekdays. Among patients admitted on a Sunday/holiday, only the subgroup of Stanford Type A showed a significantly increased risk of in-hospital mortality. (Stanford Type A, non-surgery vs. surgery groups: 95% CI 1.06-1.48 vs. 1.17-1.68, p<0.001 for both groups, OR 1.25 vs. 1.41, respectively, Stanford Type B, non-surgery vs. surgery groups: 95% CI 0.64-1.09 vs. 0.40-2.10; p = 0.182 vs. 0.846; OR 0.84 vs. 0.92).<h4>Conclusions</h4>In conclusion, patients with AAD Type A admitted on a Sunday/holiday may have an increased in-hospital mortality risk.Katsuhito KatoToshiaki OtsukaMichikazu NakaiYoko SumitaYoshihiko SeinoTomoyuki KawadaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0260152 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Katsuhito Kato Toshiaki Otsuka Michikazu Nakai Yoko Sumita Yoshihiko Seino Tomoyuki Kawada Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study.
description	<h4>Background</h4>Patients admitted on weekends have higher mortality than those admitted on weekdays. However, whether the "weekend effect" results in a higher mortality after admission for acute aortic dissection (AAD),-classified according to Stanford types-remains unclear. This study aimed to examine the association between admission day and in-hospital mortality in AAD Type A and B.<h4>Methods</h4>We used data from the Japanese registry of all Cardiac and Vascular Diseases Diagnostic Procedure Combination, a nationwide claim-based database with data from 953 certified hospitals, and enrolled in-patients with AAD admitted between April 1, 2012, and March 31, 2016. Based on the admission day, we stratified patients into groups (Weekdays, Saturdays, and Sundays/holidays). The influence of the admission day on in-hospital mortality was assessed via multi-level logistic regression analysis. We also performed a Stanford type-based stratified analysis.<h4>Results</h4>Among the included 25,641 patients, in-hospital mortality was 16.0%. The prevalence of patients admitted with AAD was relatively higher on weekdays. After adjustment for covariates, patients admitted on a Sunday/holiday showed an increased risk of in-hospital mortality (odds ratio [OR] 1.20; 95% confidence interval [CI] 1.07-1.33, p<0.001) than patients admitted on weekdays. Among patients admitted on a Sunday/holiday, only the subgroup of Stanford Type A showed a significantly increased risk of in-hospital mortality. (Stanford Type A, non-surgery vs. surgery groups: 95% CI 1.06-1.48 vs. 1.17-1.68, p<0.001 for both groups, OR 1.25 vs. 1.41, respectively, Stanford Type B, non-surgery vs. surgery groups: 95% CI 0.64-1.09 vs. 0.40-2.10; p = 0.182 vs. 0.846; OR 0.84 vs. 0.92).<h4>Conclusions</h4>In conclusion, patients with AAD Type A admitted on a Sunday/holiday may have an increased in-hospital mortality risk.
format	article
author	Katsuhito Kato Toshiaki Otsuka Michikazu Nakai Yoko Sumita Yoshihiko Seino Tomoyuki Kawada
author_facet	Katsuhito Kato Toshiaki Otsuka Michikazu Nakai Yoko Sumita Yoshihiko Seino Tomoyuki Kawada
author_sort	Katsuhito Kato
title	Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study.
title_short	Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study.
title_full	Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study.
title_fullStr	Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study.
title_full_unstemmed	Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study.
title_sort	effect of holiday admission for acute aortic dissection on in-hospital mortality in japan: a nationwide study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/1be159331c1949c19031e140f0d7166f
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Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study.

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