762 Weekend Compared to Weekday Admissions for Acute Pulmonary Embolism is associated With Increased Mortality at 30-days but not Beyond: A State-Wide Population-Linkage Study

Abstract

To date only a single study from the United States suggested weekend admission for acute pulmonary embolism (PE) is associated with increased mortality at 30-days. The present study compares acute PE mortality outcomes between patients admitted on weekends and weekdays at and beyond 30-days in the state of New South Wales (NSW), Australia. This was a retrospective population-linkage study of all NSW residents admitted with a primary diagnosis of PE between January-1, 2002 and December-31, 2017 using data from The Centre for Health Record Linkage database. Weekend admission was defined as between 5:00pm Friday and 12:00am Monday. All-cause mortality was tracked using the state-wide death registry. The study cohort comprised 46382 patients, with 10309 (22.2%) admitted on a weekend. Weekend admission was an independent risk factor for in-hospital (odds ratio [OR]=1.16, 95% confidence interval [CI]=1.04-1.31, p=0.01), and 30-days mortality (OR=1.14, 95% CI=1.03-1.25, p=0.01), but not for mortality at 3-months (hazard ratio [HR]=1.05, 95% CI=0.98-1.13, p=0.14) after adjustment for age, gender, co-morbidities, referral source, country of birth and episode year in multivariable analysis. The present study confirms that weekend admission for acute PE is associated with higher mortality and is an independent risk factor for in-hospital and 30-day mortality, but not at 3-months follow-up, when compared to weekday admission. Strategies to improve the acute management of PE patients admitted on the weekend should be developed.