New research suggests that the surgical risks associated with angioplasty procedures that are performed on the weekend are substantially higher than what patients face on during weekday procedure.
At the Society for Cardiovascular Angiography and Interventions conference in New Orleans last week, findings from a study involving more than 1 million angioplasty procedures was presented, suggesting that death rates doubled when the procedure was done on the weekend. The study is considered preliminary, as it has not yet been published in a peer reviewed journal, but raises concerns about the quality of care available during off-hours.
During an angioplasty, doctors open a narrow or blocked blood vessel using a catheter. It is placed in the thigh and guided to the heart. A balloon is then inflated to the artery to open the blockage. A stent can also be left in place to keep the blocked blood vessel open.
Researchers analyzed data from 1.3 million percutaneous coronary intervention (PCI) procedures, or more commonly referred to as an angioplasty, done in the U.S. between 2004 and 2013. Researchers said the sheer number of procedures analyzed represents 1 in 5 people in the U.S. who have had an angioplasty, making this a statistically relevant and representative study.
In 2004, weekend hospital admissions for angioplasty was about 12%. However, that number increased to 21.5% by 2013.
Death rates for patients who underwent an angioplasty on the weekend were two percent, compared to the one percent death rate for those admitted on weekdays.
The study also concluded patients who were admitted on the weekend for an angioplasty had longer hospital stays, about four days compared to three days for weekday patients.
Researchers note, the “weekend effect” seems to play a big role in this outcome. Prior studies have shown a “weekend effect” for other medical treatments, identifying higher risks associated with hospital overcrowding, decreased staffing and decreased availability of imaging and lab tests during weekends.
A study published in 2014 indicated children undergoing emergency surgery on a weekend face a greater risk of suffering severe complications, including death. Even routine surgeries that are considered safe, such as appendix removal, have increased risks if performed over the weekend, according to some research.
The “weekend effect” also affected cost. Patients admitted on the weekend had higher hospital costs, reaching $24,000 compared to $20,000 for those admitted on the weekend.