Holiday and weekend effects on mortality for acute myocardial infarction in Shanxi, China: a cross-sectional study
Xiaojun Lin1, Jeremy C Green2, Hong Xian3
1West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
Insights
Hospital admissions for acute myocardial infarction (AMI) during holidays and weekends in China are linked to higher in-hospital mortality. Specific holidays like Chinese National Day and Sundays showed increased death risks for AMI patients.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- In-hospital mortality for acute myocardial infarction (AMI) can be influenced by admission timing.
- Understanding temporal variations in healthcare access and outcomes is crucial for patient safety.
Purpose of the Study:
- To investigate the association between holiday and weekend admissions and in-hospital mortality among patients with AMI in China.
Main Methods:
- A retrospective analysis of 54,968 patients with AMI admitted to 31 tertiary hospitals in Shanxi, China (2014-2017).
- Multivariable logistic regression models were employed to assess the impact of admission timing on mortality.
Main Results:
- Holiday and weekend admissions were associated with increased risk-adjusted in-hospital mortality rates compared to non-holiday/weekday admissions.
- Chinese National Day admissions showed a 64% relative increase in mortality, while Sunday admissions had a 23% relative increase.
- No significant gender differences were observed in the holiday or weekend effects on mortality.
Conclusions:
- Admission timing during holidays and weekends is a significant factor associated with in-hospital mortality for AMI patients in China.
- Specific periods, namely Chinese National Day and Sundays, were identified as key contributors to the observed "holiday effect" and "weekend effect" on AMI mortality.
Objectives:
To examine the effects of holiday and weekend admission on in-hospital mortality for patients with acute myocardial infarction (AMI) in China.
Methods:
Patients with AMI in 31 tertiary hospitals in Shanxi, China from 2014 to 2017 were included (N = 54,968). Multivariable logistic regression models were used to examine the effects of holiday and weekend admission on in-hospital mortality.
Results:
Compared to non-holiday and weekday admissions, holiday and weekend admissions, respectively, were associated with increases in risk-adjusted mortality rates. Chinese National Day was associated with an additional 10 deaths per 1000 admissions (95% confidence interval (CI): (0, 20))-a relative increase from baseline mortality of 64% (95% CI: (1%, 128%)). Sunday was associated with an additional 4 deaths per 1000 admissions (95% CI: (0, 7))-a relative increase from baseline mortality of 23% (95% CI: (3%, 45%)). We found no evidence of gender differences in holiday or weekend effects on mortality.
Conclusions:
Holiday and weekend admissions were associated with in-hospital AMI mortality. The admissions on Chinese National Day and Sunday contributed to the observed "holiday effect" and "weekend effect," respectively.
