{"title":"Impact of Weekend Admission on Outcomes in Sinus Node Dysfunction and AV Block Undergoing Permanent Pacemaker: A Nationwide Analysis.","authors":"Julian Chestaro, Parth Adrejiya, Shahikanth Nagabandi, Rami Khouzam","doi":"10.1016/j.cpcardiol.2026.103357","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The \"weekend effect\" is associated with adverse outcomes in several cardiovascular conditions. Limited data exist regarding its impact on patients with bradyarrhythmias requiring inpatient permanent pacemaker (PPM) implantation.</p><p><strong>Methods: </strong>Retrospective study using the 2022 National Inpatient Sample to identify adults hospitalized with sinus node dysfunction (SND) or atrioventricular (AV) block who underwent PPM implantation. Patients were stratified by admission day (weekend vs weekday). The primary outcome was in-hospital mortality. Secondary outcomes included temporary pacemaker (TPM) placement, time from admission to PPM implantation, and length of stay (LOS). Survey-weighted multivariable logistic and linear regression models were used to evaluate associations between weekend admission and outcomes.</p><p><strong>Results: </strong>A total of 29,630 patients with SND and 44,150 patients with AV block undergoing PPM implantation were included. Among patients with SND, weekend admission was not associated with higher in-hospital mortality (adjusted odds ratio [aOR] 1.10; 95% CI 0.42-2.85) or TPM placement (aOR 1.13; 95% CI 0.86-1.48) but was associated with delayed PPM implantation (2.37 vs 2.02 days; p<0.001) and longer LOS (4.55 vs 4.27 days; p=0.006). Among patients with AV block, weekend admission was not associated with increased mortality (aOR 1.05; 95% CI 0.59-1.84) but was associated with higher TPM placement (aOR 1.53; 95% CI 1.34-1.75; p<0.001), delayed PPM implantation (1.89 vs 1.48 days; p<0.001), and longer LOS (4.30 vs 3.73 days; p<0.001).</p><p><strong>Conclusion: </strong>Weekend admission among patients with SND or AV block requiring PPM implantation was not associated with increased in-hospital mortality but was linked to delayed device implantation and longer hospitalization.</p>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":" ","pages":"103357"},"PeriodicalIF":3.3000,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Problems in Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cpcardiol.2026.103357","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The "weekend effect" is associated with adverse outcomes in several cardiovascular conditions. Limited data exist regarding its impact on patients with bradyarrhythmias requiring inpatient permanent pacemaker (PPM) implantation.
Methods: Retrospective study using the 2022 National Inpatient Sample to identify adults hospitalized with sinus node dysfunction (SND) or atrioventricular (AV) block who underwent PPM implantation. Patients were stratified by admission day (weekend vs weekday). The primary outcome was in-hospital mortality. Secondary outcomes included temporary pacemaker (TPM) placement, time from admission to PPM implantation, and length of stay (LOS). Survey-weighted multivariable logistic and linear regression models were used to evaluate associations between weekend admission and outcomes.
Results: A total of 29,630 patients with SND and 44,150 patients with AV block undergoing PPM implantation were included. Among patients with SND, weekend admission was not associated with higher in-hospital mortality (adjusted odds ratio [aOR] 1.10; 95% CI 0.42-2.85) or TPM placement (aOR 1.13; 95% CI 0.86-1.48) but was associated with delayed PPM implantation (2.37 vs 2.02 days; p<0.001) and longer LOS (4.55 vs 4.27 days; p=0.006). Among patients with AV block, weekend admission was not associated with increased mortality (aOR 1.05; 95% CI 0.59-1.84) but was associated with higher TPM placement (aOR 1.53; 95% CI 1.34-1.75; p<0.001), delayed PPM implantation (1.89 vs 1.48 days; p<0.001), and longer LOS (4.30 vs 3.73 days; p<0.001).
Conclusion: Weekend admission among patients with SND or AV block requiring PPM implantation was not associated with increased in-hospital mortality but was linked to delayed device implantation and longer hospitalization.
背景：“周末效应”与几种心血管疾病的不良结局有关。关于其对需要住院永久起搏器（PPM）植入的慢型心律失常患者的影响，目前的数据有限。方法：对2022年全国住院患者样本进行回顾性研究，以确定因窦房结功能障碍（SND）或房室（AV）传导阻滞而住院的成人进行PPM植入。患者按入院日期（周末与工作日）分层。主要终点是住院死亡率。次要结果包括临时起搏器（TPM）放置，从入院到PPM植入的时间和住院时间（LOS）。采用调查加权多变量logistic和线性回归模型来评估周末入院与预后之间的关系。结果：共有29630例SND患者和44150例AV阻滞患者行PPM植入。在SND患者中，周末入院与更高的住院死亡率（调整优势比[aOR] 1.10; 95% CI 0.42-2.85）或TPM放置（aOR 1.13; 95% CI 0.86-1.48）无关，但与延迟PPM植入相关（2.37 vs 2.02天）。结论：需要PPM植入的SND或AV阻断患者的周末入院与住院死亡率增加无关，但与延迟装置植入和更长住院时间有关。
期刊介绍：
Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.
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