Utilization of coronary interventions and outcomes in weekend versus weekday admissions for stemi complicated by cardiogenic shock
Butera B, Lemor A, Ya'qoub L, Arman PD, Voeltz M, Koenig G, Alaswad K, O'Neill WW, and Basir M. Utilization of coronary interventions and outcomes in weekend versus weekday admissions for stemi complicated by cardiogenic shock. Journal of the American College of Cardiology 2020; 75(11):1541.
J Am Coll Cardiol
Background ST-elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) is associated with high mortality. We evaluated if there was a difference in the utilization of coronary interventions in patients who present with STEMI associated with CS. Methods The National Inpatient Sample, a publicly available database intended to represent 20% of all annual United States hospital admissions was searched for consecutive admission in patients >18 years old from 2006 to 2015 who presented with STEMI and CS. A comparison of procedural interventions, use of hemodynamic monitoring, implementation of mechanical support and outcomes for weekday versus weekend admissions was recorded. Results 186,316 admissions for STEMI with CS were identified. There was no significant difference in adjusted mortality (OR 1.01, 95% CI: 0.96-1.06, p=0.72). The utilization of PCI was higher in weekend admissions (OR 1.10, 95% CI: 1.04-1.16, p=0.001) but the use of CABG (OR 0.94, 95% CI: 0.87-1.01, p=0.09), right heart catheterization (OR 0.96, 95% CI: 0.89-1.02, p=0.19), ECMO (OR 0.91, 95% CI: 0.71-1.18, p=0.48), percutaneous ventricular assist device (OR.91, 95% CI: 0.79-1.05, p=0.19) and IABP (OR 1.03, 95% CI 0.98-1.08, p=0.27) was similar in weekend versus weekday admissions. Conclusion There was no observed difference in the utilization of invasive procedures or outcomes in patients who are admitted with STEMI complicated by CS based on weekday and weekend admission.