{"title":"入院日期对完全性心脏传导阻滞患者的影响：分析周末效应","authors":"Nahush Roop Bansal , Abdulmajeed Alharbi , Shahnaz Rehman , Ragheb Assaly","doi":"10.1016/j.hrtlng.2024.10.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Complete heart block (CHB) is a conduction disorder that can be fatal if not treated promptly. Admission on a week or weekend day may influence the outcomes of cardiac emergencies, such as CHB.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to determine the effects of weekday vs. weekend admissions in terms of CHB outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using the National Inpatient Sample database to study the outcomes of adult patients admitted with complete heart block. Outcomes were compared between the patients admitted on weekends (midnight Friday to midnight Sunday) and weekdays.</div></div><div><h3>Results</h3><div>Thirty-four thousand three hundred ninety-five patients were included, of which 7350 (21.37 %) were admitted on weekends. Mean age for included patients was 75.69 years, with 43.23 % females. Compared to those admitted on weekdays, participants admitted on weekends had similar mortality (aOR 0.73; 95 % CI 0.46–1.16), longer length of stay (mean increase 0.74 days; <em>P</em> < 0.01) and higher hospital charges (mean increase $10,540.82; <em>P</em> < 0.01). Weekend admissions were associated with higher rates of cardiac arrest (adjusted OR 1.40; 95 % CI 1.07–1.84; <em>P</em> = 0.02) and higher rates of cardiogenic shock (adjusted OR 1.40; 95 % CI 1.07–1.83; <em>P</em> = 0.01) and similar rates of permanent pacemaker implantation (adjusted OR 0.88; 95 % CI 0.77–1.01; <em>P</em> = 0.06), but had longer delay to permanent pacemaker (mean increase 0.46 days; <em>P</em> < 0.01).</div></div><div><h3>Conclusion</h3><div>Hospital and administrative-level strategies are needed to address the differences between the weekend and weekday CHB admissions.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"69 ","pages":"Pages 168-173"},"PeriodicalIF":2.4000,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of day of admission on patients admitted with complete heart block: Analyzing the weekend effect\",\"authors\":\"Nahush Roop Bansal , Abdulmajeed Alharbi , Shahnaz Rehman , Ragheb Assaly\",\"doi\":\"10.1016/j.hrtlng.2024.10.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Complete heart block (CHB) is a conduction disorder that can be fatal if not treated promptly. Admission on a week or weekend day may influence the outcomes of cardiac emergencies, such as CHB.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to determine the effects of weekday vs. weekend admissions in terms of CHB outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using the National Inpatient Sample database to study the outcomes of adult patients admitted with complete heart block. Outcomes were compared between the patients admitted on weekends (midnight Friday to midnight Sunday) and weekdays.</div></div><div><h3>Results</h3><div>Thirty-four thousand three hundred ninety-five patients were included, of which 7350 (21.37 %) were admitted on weekends. Mean age for included patients was 75.69 years, with 43.23 % females. Compared to those admitted on weekdays, participants admitted on weekends had similar mortality (aOR 0.73; 95 % CI 0.46–1.16), longer length of stay (mean increase 0.74 days; <em>P</em> < 0.01) and higher hospital charges (mean increase $10,540.82; <em>P</em> < 0.01). Weekend admissions were associated with higher rates of cardiac arrest (adjusted OR 1.40; 95 % CI 1.07–1.84; <em>P</em> = 0.02) and higher rates of cardiogenic shock (adjusted OR 1.40; 95 % CI 1.07–1.83; <em>P</em> = 0.01) and similar rates of permanent pacemaker implantation (adjusted OR 0.88; 95 % CI 0.77–1.01; <em>P</em> = 0.06), but had longer delay to permanent pacemaker (mean increase 0.46 days; <em>P</em> < 0.01).</div></div><div><h3>Conclusion</h3><div>Hospital and administrative-level strategies are needed to address the differences between the weekend and weekday CHB admissions.</div></div>\",\"PeriodicalId\":55064,\"journal\":{\"name\":\"Heart & Lung\",\"volume\":\"69 \",\"pages\":\"Pages 168-173\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-10-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart & Lung\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0147956324001973\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart & Lung","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0147956324001973","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：完全性心脏传导阻滞（CHB完全性心脏传导阻滞（CHB）是一种传导障碍，如不及时治疗可能致命。在工作日或周末入院可能会影响心脏急症（如 CHB）的治疗效果：本研究旨在确定工作日与周末入院对 CHB 预后的影响：方法：利用全国住院病人抽样数据库进行了一项回顾性队列研究，以了解因完全性心脏传导阻滞而入院的成年病人的治疗效果。比较了周末（周五午夜至周日午夜）和工作日入院患者的治疗效果：共纳入 34395 名患者，其中 7350 人（21.37%）在周末入院。患者平均年龄为 75.69 岁，女性占 43.23%。与平日入院的患者相比，周末入院的患者死亡率相似（aOR 0.73；95 % CI 0.46-1.16），住院时间更长（平均增加 0.74 天；P < 0.01），住院费用更高（平均增加 10540.82 美元；P < 0.01）。周末入院与较高的心脏骤停发生率（调整后 OR 1.40；95 % CI 1.07-1.84；P = 0.02）和较高的心源性休克发生率（调整后 OR 1.40；95 % CI 1.07-1.83；P = 0.01），永久性心脏起搏器植入率相似（调整后 OR 0.88；95 % CI 0.77-1.01；P = 0.06），但植入永久性心脏起搏器的延迟时间更长（平均增加 0.46 天；P < 0.01）：结论：需要在医院和管理层面制定策略，以解决周末和平日慢性阻塞性肺病入院率之间的差异。
Impact of day of admission on patients admitted with complete heart block: Analyzing the weekend effect
Background
Complete heart block (CHB) is a conduction disorder that can be fatal if not treated promptly. Admission on a week or weekend day may influence the outcomes of cardiac emergencies, such as CHB.
Objectives
The purpose of this study was to determine the effects of weekday vs. weekend admissions in terms of CHB outcomes.
Methods
A retrospective cohort study was conducted using the National Inpatient Sample database to study the outcomes of adult patients admitted with complete heart block. Outcomes were compared between the patients admitted on weekends (midnight Friday to midnight Sunday) and weekdays.
Results
Thirty-four thousand three hundred ninety-five patients were included, of which 7350 (21.37 %) were admitted on weekends. Mean age for included patients was 75.69 years, with 43.23 % females. Compared to those admitted on weekdays, participants admitted on weekends had similar mortality (aOR 0.73; 95 % CI 0.46–1.16), longer length of stay (mean increase 0.74 days; P < 0.01) and higher hospital charges (mean increase $10,540.82; P < 0.01). Weekend admissions were associated with higher rates of cardiac arrest (adjusted OR 1.40; 95 % CI 1.07–1.84; P = 0.02) and higher rates of cardiogenic shock (adjusted OR 1.40; 95 % CI 1.07–1.83; P = 0.01) and similar rates of permanent pacemaker implantation (adjusted OR 0.88; 95 % CI 0.77–1.01; P = 0.06), but had longer delay to permanent pacemaker (mean increase 0.46 days; P < 0.01).
Conclusion
Hospital and administrative-level strategies are needed to address the differences between the weekend and weekday CHB admissions.
期刊介绍：
Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders.
The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.
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