Abstract 201: Weekend Effect On Pulmonary Embolism: Real World Data

Background: Pulmonary embolism (PE) is associated with high morbidity and mortality, there is paucity of data regarding the outcomes of patients with acute high-risk PE presenting on weekends, weekend Effect stems from reductions in staff availability, lack of highly trained endovascular subspecialists to conduct timely therapeutic procedures or inadequate intensive care facilities.

Methods: We queried the Nationwide Readmissions Database (2016-2019) using ICD-10 codes for patients presenting with acute PE as primary diagnosis, we classified the patients into 2 groups based on whether patients were admitted on weekends or weekdays. We performed a subgroup analysis of patients presenting with high risk PE (shock or cardiac arrest) during the index admission. Outcomes were in-hospital death, stroke (composite of ischemic, hemorrhagic strokes &TIA), intracranial bleed (IC), gastrointestinal (GI) bleed, and 90-day readmission rates.

Results: 167,522, and 55352 patients were admitted on weekends and weekdays, in hospital-mortality was higher for patients presenting on weekends (3.2% vs 2.9%, p<0.0001). Length of stay and total charges were similar between both groups. Weekends’ group had higher readmission rate within 90 days (14.0 vs. 13.6%, p=0.03). Causes of readmissions were also similar (table1). 5,889 and 17,532 patients were admitted on weekends and weekdays with high-risk PE (shock or cardiac arrest). In-hospital mortality rate was not different between groups 45.2% vs. 44.0%, P=0.4, respectively.

Conclusion: PE patients admitted on weekends have higher mortality rates compared to patients admitted on weekdays. Of those surviving index admissions, weekend patients were also more likely to be readmitted at 90 days. Strategies to mitigate this Weekend Effect should be further explored to reduce mortality and complications.