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

## TL;DR

This study finds that patients admitted on weekends for aortic dissection surgery have higher mortality rates compared to those admitted on weekdays.

## Contribution

The study reveals a weekend effect on mortality for type A aortic dissection surgery using a nationwide database.

## Key findings

- Weekend admissions for TAAD were associated with higher in-hospital mortality (17.3% vs 15.4%).
- Weekend admissions showed increased risk in multivariate analysis compared to weekday admissions.
- Neurologic, coronary, and renal malperfusion were more common in weekend admissions.

## Abstract

Weekend admission has been shown to influence outcomes with surgical and medical conditions. This study aimed to evaluate if surgical outcomes for acute type A aortic dissection (TAAD) vary based on weekday or weekend admission.

The Nationwide Readmissions Database was queried for hospitalizations with TAAD as a primary diagnosis that underwent surgical procedures over a 5-year period. The association between TAAD and outcomes (in-hospital mortality, days to procedure, length of stay, hospital costs, and re-admission) based on day of admission (weekday versus weekend) was examined.

A total of 14 260 patients admitted to the hospital with TAAD (10 582 [74.2%] weekdays and 3678 [25.8%] weekends) were included in this analysis. Patients admitted on the weekdays tended to be older, and more commonly had undergone prior cardiac surgery. Neurologic, coronary, and renal malperfusion were more common in patients admitted on the weekend. Compared to weekday admissions with aortic dissection, weekend admissions were associated with higher in-hospital mortality (17.3% vs 15.4%, P = .027) and also associated with increased risk in a multivariate analysis. Large hospital size and teaching status also had more favourable outcomes in the multivariate analysis.

While known aortic dissection risk factors significantly impact TAAD survival, patients admitted on weekends also demonstrate a higher mortality rate.

Acute type A aortic dissection (TAAD) requires early recognition and surgical treatment with patients benefitting from surgical expertise and multidisciplinary coordination of care.