Comparison of acute aortic dissection in hospital mortality between weekdays and weekends
Abstract
Few studies have evaluated and compared the hospital mortality rate of acute aortic dissection between regular days of the week and holidays. If there is higher mortality on holidays, we should use hospital strategies to provide faster access to diagnostic procedures such as CT angiography, esophageal echo, and surgery on holidays.
Methods: In this cross-sectional descriptive study, after the ethics committee's approval and based on the inclusion and exclusion criteria for patients, the patients were divided into two groups. The first group included acute aortic dissection on regular days of the week and the second group included acute aortic dissection on weekdays (2 noon Thursday to 8 am Saturday + holidays from 12 pm the day before to 8 am the next day). These two groups are based on designed checklists, including demographic information, clinical findings, pathogenesis, modality. Diagnosis, treatment intervention, and hospital mortality were assessed. Each patient's information was completed by data collection form, and finally, the data were entered into SPSS 26 statistical software. In this study P-value < 0.05 was found to be significant.
Results: Between 2011 and 2020, 210 patients referred to the Civil Hospital were diagnosed with acute aortic dissection. There was no significant difference between the sexes and age of patients with their referral on a regular day or holiday. There was no significant difference between different pathogenesis, clinical symptoms, diagnostic modalities, and dissection therapeutic interventions between regular days and holidays, and the p-value in all of them was more than 0.05. Although the mortality rate of patients with type A and type B aortic dissection was higher on holidays than on normal days, there was no significant difference. (P-value = 0.217, and P-value =0.815) Among 151 patients with surgical dissection type A, the mortality rate on normal days of the week was 45 (39.8%) and on holidays of the week 23 (60.5%). This difference was statistically significant. (P-value =0.026)