Impact of Weekend Admission on Outcomes in Sinus Node Dysfunction and AV Block Undergoing Permanent Pacemaker: A Nationwide Analysis.

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.