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Does acute myocardial infarction kill more people on weekends? Analysis of in-hospital mortality rates for weekend admissions in Portugal

dc.contributor.authorFiorentino, Francesca
dc.contributor.authorAscenção, Raquel
dc.contributor.authorRosati, Nicoletta
dc.date.accessioned2018-05-07T11:24:43Z
dc.date.available2018-05-07T11:24:43Z
dc.date.issued2018
dc.description©The Author(s) 2018pt_PT
dc.description.abstractObjectives: To investigate a possible weekend effect in the in-hospital mortality rate for acute myocardial infarction in Portugal, and whether the delay in invasive intervention contributes to this effect. Methods: Data from the National 2011-2015 Diagnostic-Related-Group databases were analysed. The focus was on adult patients admitted via the emergency department and with the primary diagnosis of acute myocardial infarction. Patients were grouped according to ST-elevation myocardial infarction and non-ST-elevation myocardial infarction episodes. We employed multivariable logistic regressions to determine the association between weekend admission and in-hospital mortality, controlling for episode complexity (through a severity index and acute comorbidities), demographic characteristics and hospital identifications. The association between the probability of a prompt surgery (within one day) and the day of admission was investigated to explore the possible delay of care delivery for patients admitted during weekends. Results: Our results indicate that in-hospital mortality rates were not significantly higher for weekend admissions than for weekday admissions in both ST-elevation myocardial infarction (STEMI) and non-STEMI episodes. This result is robust to the inclusion of a number of potential confounding mechanisms. Patients admitted on weekends had lower probabilities of undergoing invasive cardiac surgery within the day after admission, but delay in care delivery during the weekend was not associated with worse outcomes in terms of in-hospital mortality. Conclusions: There is no evidence for the existence of a weekend effect due to admission for acute myocardial infarction in Portugal, in both STEMI and non-STEMI episodes.pt_PT
dc.description.sponsorshipThe author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Nicoletta Rosati gratefully acknowledges the financial support from the Fundação para a Ciência and Tecnologia (FCT Portugal) through Project CEMAPRE – UID/MULTI/00491/2013.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJournal of Health Services Research & Policy. Volume: 23 issue: 2, page(s): 87-9pt_PT
dc.identifier.doi10.1177/1355819617750687pt_PT
dc.identifier.issn1355-8196
dc.identifier.urihttp://hdl.handle.net/10451/33167
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSAGE Publicationspt_PT
dc.relationUID/ MULTI/00491/2013pt_PT
dc.relation.publisherversionhttps://uk.sagepub.com/en-gb/eur/journal/journal-health-services-research-policypt_PT
dc.subjectAcute myocardial infarctionpt_PT
dc.subjectEmergency servicespt_PT
dc.subjectIn-hospital mortalitypt_PT
dc.subjectPortugalpt_PT
dc.subjectWeekend effectpt_PT
dc.titleDoes acute myocardial infarction kill more people on weekends? Analysis of in-hospital mortality rates for weekend admissions in Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage97pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage87pt_PT
oaire.citation.titleJournal of Health Services Research and Policypt_PT
oaire.citation.volume23pt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT

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