Journal of Cardiology and Cardiovascular Medicine Open Access HTTPS://WWW.HEIGHPUBS.ORG ISSN 2575-0143 Research Article Procedure utilization, latency and mortality: Weekend versus Weekday admission for Myocardial Infarction Nader Makki 3 , David M Kline 3 , Arun Kanmanthareddy 1 , Hansie Mathelier 2 , Satya Shreenivas 2 and Scott M Lilly 2 * 1 Creighton University School of Medicine, Omaha NE, USA 2 Department of Cardiovascular Medicine, Ohio State’s Wexner Medical Center, Columbus, Ohio, USA 3 Center for Biostatistics, Department of Biomedical Informatics, the Ohio State University, Columbus, Ohio, USA *Address for Correspondence: Scott Lilly, MD, 410 W 10 th Ave 1 Maloney Building Columbus, OH 43210, Tel: (614) 293-7677; Fax: (614) 293- 5614; E-mail: Scott.Lilly@osumc.edu Submitted: 04 March 2017 Approved: 17 May 2017 Published: 19 May 2017 Copyright: 2017 Makki N, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Keywords: Acute myocardial infarction; Mortality; Weekend admissions; Weekday admissions How to cite this article: Makki N, Kline DM, Kanmanthareddy A, Mathelier H, Shreenivas S, et al. Procedure utilization, latency and mortality: Weekend versus Weekday admission for Myocardial Infarction. J Cardiol Cardiovasc Med. 2017; 2: 020-025. https://doi.org.10.29328/journal.jccm.1001008 ABSTRACT Background: Due to variations in hospital protocols and personnel availability, individuals with myocardial infarction admitted on the weekend may be less likely to receive invasive procedures, or may receive them with a greater latency than those admitted during the week. Whether or not this occurs, and translates into a difference in outcomes is not established. Methods: Using the Nationwide Inpatient Sample (2008-2011) database, we identified all patients admitted with a principle diagnosis of acute myocardial infarction. They were stratified by weekend or weekday admission. Baseline clinical characteristics, procedure utilization and latency to procedure were compared, and logistic regression models were constructed to assess the relationship between these variables and in-hospital mortality. Results: Patient demographics and provider-related characteristics (hospital type, geography) were similar between weekend and weekday admission for myocardial infarction. Adjusted for covariates, we found that the odds of mortality for a weekend admission are 5% greater than for a weekday admission (OR: 1.05; 95% CI: 1.01, 1.09, p=0.009). For the utilization of an invasive procedure, we found that the odds of receiving a procedure for a weekend admission were 12% less than the odds for a weekday admission, adjusted for the other covariates (OR: 0.88; 95% CI: 0.86, 0.91, p<0.001). In addition, we found that the time to procedure was an average of 0.18 days (4.32 hours) longer for weekend admissions compared to weekday admissions (95% CI: 0.16, 0.20, p<0.001). However, we did not observe a significant difference in the overall length of stay for weekend and weekday admissions (0.004 days; 95% CI: -0.04, 0.05, p=0.87). Conclusion: In a large and diverse subset of patients admitted with myocardial infarction, weekend admission was associated with fewer procedures, increased latency to those procedures, and a non-significant trend towards greater in adjusted in-hospital mortality. INTRODUCTION Timely invasive angiography is associated with reductions in mortality in acute coronary syndromes (ACS) and is the current standard of care enforced by multiple guidelines [1,2]. While urgent and emergent angiography are routinely available at percutaneous coronary intervention (PCI)-capable hospitals; the latency to these procedures may be affected by availability of staff. Additionally, with Non-ST elevation acute coronary syndromes, guidelines suggest stable patients may receive angiography within 24-48 hours [3-5]. Whether or not stafϐing patterns dictate this interval, and what effect that may have on patient outcomes, is unclear. There have been a few