P816Mortality during weekend admission for takotsubo syndrome: a national cross sectional large scale study

Abstract

Abstract Background Higher mortality rates in patients admitted for an acute myocardial infarction during weekends has been recently confirmed. Differences in staffing and in lower rates of early reperfusion therapy are thought to affect outcomes of these patients particularly of those presenting with ST segment elevation. Patients affected by Takotsubo cardiomyopathy may present themselves mimicking those affected by heart attack and are frequently admitted with supposed diagnosis of acute coronary syndrome. No data is available about influence on mortality in relation to the time of admission among patients with Takotsubo cardiomyopathy. Rationale The aim of this study is to assess the effect on mortality due to admission during weekend among patients discharged with diagnosis of Takotsubo cardiomyopathy. Methods We retrieved administrative data about every admission to National Healthcare System hospitals in Italy between 2009 and 2017 with final diagnosis of Takotsubo cardiomyopathy according to ICD9-CM classification of diseases (code 429.83). Date of admission was used to determine the weekend (Saturday and Sunday) or weekdays exposure (Monday to Friday). The primary outcome was in-hospital mortality. Demographical characteristics of patients (age and sex) were included in a multivariate logistic regression analysis. We also analyzed the impact of weekend admission on time to coronary angiography and on length of hospital staying. Analyses were performed using Stata 13.0. Results A total of 10,861 Takotsubo admissions were identified. Mean age was 70.7 years and 91.7% were women. The in-hospital mortality was 2.21%. We found that there was no significant increase in the risk of death among patients admitted during weekends (OR 1.07; 95% CI 0.77–1.44). The variability explained by the model was of 4.2% (pseudo R-squared 0.042). Men have a higher risk of mortality as compared to women (OR 2.37, 95% C.I 1.69–3.33). Patients admitted during weekend tends to stay in hospital longer, but they do not seem to wait more days to get a coronary angiography. Conclusions At variance with patients with ST elevated acute myocardial infarction, subjects admitted during weekends for Takotsubo cardiomyopathy did not show an excess of in-hospital mortality in comparison to those admitted during week days.