Comparison of outcomes of weekend versus weekday admissions for atrial fibrillation

Previous studies have identified a "weekend effect" in terms of a poor outcome for patients hospitalized with various acute medical conditions. The aim of our study was to investigate whether weekend admissions for atrial fibrillation (AF) result in worse outcomes than those admitted on weekdays. In the Nationwide Inpatient Sample 2008 database, we identified a total of 86,497 discharges with a primary discharge diagnosis of AF. The use of a cardioversion procedure for AF on weekends was lower than that on a weekday (7.9% vs 16.2%; p <0.0001; odds ratio 0.5, 95% confidence interval 0.45 to 0.55, p <0.0001). After adjusting for patient and hospital characteristics and disease severity, the adjusted in-hospital mortality odds were greater for weekend admissions (odds ratio 1.23, 95% confidence interval 1.03 to 1.51; p <0.0001). The length of stay was significantly longer for weekend admissions. In conclusion, patients admitted with AF on weekends had lower odds of undergoing a cardioversion procedure and greater odds of dying.