Comparison of Resource Utilization and Survival on Weekend versus Weekday Admissions in Patients with Out of Hospital Cardiac Arrest

Background:
Data regarding management and outcomes of patients with out of hospital cardiac arrest (OHCA) admitted on weekend versus weekday is limited.

Methods:
We used the Nationwide Inpatient Sample database (2010 to 2014) to compare differences in all-cause in-hospital mortality between patients admitted on a weekend versus weekday for an OHCA due to ventricular tachycardia/ventricular fibrillation and to determine if utilization of interventions contributed to this difference.

Results:
A total of 117,990 OHCA admissions were identified, of which 30,394 (25.8%) were weekend and 87,596 (74.2%) were weekday admissions. Admission on a weekend versus weekday was independently associated with lower rates of intra-aortic-balloon pump (IABP) use, extracorporeal membrane oxygenation (ECMO) use and overall mechanical circulatory support (MCS) devices use. Weekend admissions were associated with higher rates of angiography use, and therapeutic hypothermia (TH). Unadjusted in-hospital mortality was significantly higher for the cohort of patients admitted on weekends [OR1.11 (1.08-1.14); P<0.001]. After adjusting for age, sex, STEMI, use of MCS devices, coronary angiogram and TH, survival remained worse for weekend OHCA compared to weekdays [OR 1.18 (1.15-1.22; p<0.001].

Conclusions:
OHCA admission on weekend is associated with worse survival compared to weekdays even after adjusting for resource utilization in terms of MCS use and coronary angiogram.