Mortality risk from acute aortic dissection among hospital admissions during weekends and holiday season

• Published in: PloS one 2021-09, Vol.16 (9), p.e0255942-e0255942
• Main Authors: Su, I-Min, Huang, Huei-Kai, Liu, Peter Pin-Sung, Hsu, Jin-Yi, Lin, Shu-Man, Loh, Ching-Hui
• Format: Article
• Language: English
• Subjects: Accreditation; Admission and discharge; Aging; Aorta; Aortic dissection; Biology and Life Sciences; Buddhism; Codes; Comorbidity; Complications and side effects; Data collection; Dissecting aneurysm; Dissection; Evaluation; Health insurance; Health policy; Health risks; Holidays & special occasions; Hospitalization; Hospitals; Medical prognosis; Medical records; Medicine; Medicine and Health Sciences; Mortality; New year; Patient outcomes; Patients; People and Places; Risk; Seasons; Statistical analysis; Subgroups; Workforce planning
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0255942

Acute aortic dissection is a life-threatening condition associated with high mortality rate. Findings from previous studies addressing the "weekend effect" on the mortality rate from an acute aortic dissection mortality have been inconsistent. Furthermore, the effect of admission for acute aortic dissection during the holiday season has not been previously investigated. Our aim was to evaluate the effect of admission for acute aortic dissection during holiday season or weekends on the risk of mortality. We conducted a retrospective analysis of nationwide cohort data from the Taiwan's National Health Insurance Research Database. We collected data on all adult patients hospitalized for acute aortic dissection between 2001 and 2017 in Taiwan and classified them into the following three groups based on day of admission: holiday season (at least 4 consecutive days; n = 280), weekend (n = 1 041), and weekday (n = 3 109). The following three outcomes were evaluated: in-hospital mortality, 7-day mortality, and 180-day mortality. A multivariable logistic regression was used to adjust for possible cofounders on the measured outcomes. Compared to weekday admissions for acute aortic dissection, weekend admissions resulted in a 29% increase in the risk of in-hospital death (aOR = 1.29; 95% CI, 1.05-1.59; P = 0.0153), with a 25% increase in the 7-day (aOR = 1.25; 95% CI, 1.001-1.563; P = 0.0492) and 20% increase in the 180-day mortality risk (aOR = 1.20; 95% CI, 1.01-1.42; P = 0.0395). Of note, admission over the holiday season did not result in a higher mortality risk than for weekday admissions; this finding, however, might reflect insufficient statistical power on subgroup analysis.