School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung 40447, Taiwan.
Eur Heart J Cardiovasc Pharmacother. 2022 Jun 8;8(4):346-352. doi: 10.1093/ehjcvp/pvab047.
We conducted this study to explore the associations of weekend and weekday admission with the clinical events among heart failure (HF) patients with and without comorbid atrial fibrillation (AF).
In this study, we recruited 57 919 HF patients without AF hospitalized on weekends and 57 919 HF patients without AF hospitalized on weekdays. There were 21407 and 21407 HF patients with AF hospitalized on weekends and weekdays, respectively. The outcomes of interest included all-cause mortality, cardiovascular (CV) death, and HF recurrence requiring admission. The Cox proportional hazard regression model was applied to estimate the hazard ratio. Variables found to be statistically significant in a univariable Cox proportional hazard regression model were further examined in a multivariable Cox proportional hazard regression model. The cumulative incidence curves were obtained by the Kaplan-Meier method and assessed by the log-rank test. HF patients with AF and hospitalized on weekends had the highest incidence rates of rehospitalization due to HF (233.8 per 1000 person-years) and CV death (23.9 per 1000 person-years) among four groups. The Kaplan-Meier method shows that HF patients with AF had the higher cumulative incidence of rehospitalization due to HF than the patients without AF.
HF patients with AF and hospitalized on weekends are at highest risk of HF recurrence requiring hospitalization among these four groups.
本研究旨在探讨合并或不合并心房颤动（AF）的心力衰竭（HF）患者在周末和工作日入院与临床事件的相关性。
本研究共纳入 57919 例周末无 AF 的 HF 患者和 57919 例工作日无 AF 的 HF 患者。分别有 21407 例和 21407 例合并 AF 的 HF 患者在周末和工作日入院。主要观察终点为全因死亡率、心血管（CV）死亡和需要入院的 HF 复发。应用 Cox 比例风险回归模型估计风险比。单变量 Cox 比例风险回归模型中发现有统计学意义的变量在多变量 Cox 比例风险回归模型中进一步进行了检验。采用 Kaplan-Meier 法绘制累积发病率曲线，采用对数秩检验进行评估。在四个组中，合并 AF 且在周末住院的 HF 患者因 HF（233.8/1000 人年）和 CV 死亡（23.9/1000 人年）再住院的发生率最高。Kaplan-Meier 法表明，合并 AF 的 HF 患者的 HF 再住院累积发生率高于不合并 AF 的 HF 患者。
在这四个组中，合并 AF 且在周末住院的 HF 患者因 HF 再住院的风险最高。
