It seems even interventional cardiologists aren’t immune to the “Weekend Effect” as a recent study suggests patients admitted on weekends for TAVR procedures face significantly higher risks.
- The “weekend effect” is a well-documented phenomenon in hospital care, often linked to reduced staffing levels, leading to potential delays in diagnosis and intervention.
- Weekend procedures also face limited access to specialized cardiac teams, affecting timely decisions and making urgent procedures more difficult to schedule.
To uncover the weekend effect’s impact on TAVR, researchers analyzed over 82k TAVR hospitalizations between 2013 and 2021 and revealed that weekend patients faced a 45% higher risk of in-hospital mortality compared to weekday admissions.
- Beyond in-hospital mortality, weekend patients faced a 3.27x higher risk of death following the procedures.
Patients admitted on weekends also experienced higher rates of a range of complications:
- Paravalvular leakage (0.97% vs. 0.59%)
- Cardiogenic shock (7.59% vs. 3.97%)
- Permanent pacemaker implantation (11.12% vs. 9.25%)
- Endocarditis (0.74% vs. 0.37%)
- Cardiac arrest (2.19% vs. 1.65%)
- Acute kidney injury (29.76% vs. 19.56%)
- Acute ischemic stroke (2.94% vs. 1.92%)
- Blood transfusion (13.32% vs. 9.67%)
It appears that weekend procedures are bad for hospitals too. Weekend patients were hospitalized twice as long (8 vs. 4 days), costing hospitals almost $28,000 more per patient ($249k vs. $222.9k).
Despite these strong statistical findings, the study’s authors do warn of a few potential weaknesses due to the retrospective nature of their data.
- Researchers were not able to assess unmeasured confounding factors such as biomarker levels, socioeconomic factors, nursing care level, and medication adherence.
- The dataset only categorized admissions as “weekend” or “weekday” without specifying the day, so late Friday admissions may have been affected more than late Sunday admissions.
The Takeaway
We all love our time off, but these findings emphasize the need for improved weekend care strategies in hospitals performing TAVR – especially as the growing popularity of the procedure puts more patients at risk.
