The Weekend Effect on Outcomes for Type A Aortic Dissection Surgery: A Nationwide Analysis

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Disease Research

Background:

• Weekend hospital admissions are linked to varied patient outcomes.
• Acute Type A aortic dissection (TAAD) is a life-threatening surgical emergency.
• Understanding factors influencing TAAD outcomes is crucial for patient survival.

Purpose of the Study:

• To investigate if surgical outcomes for acute Type A aortic dissection (TAAD) differ between weekday and weekend admissions.
• To analyze the impact of admission timing on mortality, procedure timing, length of stay, costs, and readmissions for TAAD patients.

Main Methods:

• Utilized the Nationwide Readmissions Database for a 5-year period.
• Included hospitalizations with TAAD as the primary diagnosis undergoing surgery.
• Compared outcomes between weekday and weekend admission cohorts.

Main Results:

• Analyzed 14,260 TAAD patients (74.2% weekday, 25.8% weekend admissions).
• Weekend admissions showed higher in-hospital mortality (17.3% vs. 15.4%, p=0.027).
• Weekend admissions were associated with increased risk in multivariate analysis; malperfusion was more common.

Conclusions:

• Weekend admission for TAAD is associated with significantly higher in-hospital mortality.
• Known TAAD risk factors remain critical, but admission timing also impacts survival.
• Optimizing care delivery across all admission days is essential for improving TAAD outcomes.