ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
The weekend effect in atrial fibrillation hospitalizations: a nationwide analysis of outcomes and interventions.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrevious studies have suggested that patients admitted on the weekend may experience worse outcomes compared to weekday admissions, a phenomenon known as the "weekend effect." Atrial fibrillation (AF) management has evolved substantially in recent years, prompting a re-evaluation of whether the weekend effect persists in this population using more recently updated national data.
methodsWe conducted a retrospective review using the 2022 National Inpatient Sample (NIS), analyzing adult hospitalizations with a primary diagnosis of atrial fibrillation. Weekday admissions were compared to weekend admissions. The primary outcome was receipt of cardioversion. Secondary outcomes included mortality, length of stay (LOS), and total hospital charges. Multivariate linear and logistic regression models were used to adjust for demographic, clinical, and hospital-level confounders.
resultsAmong 277,440 hospitalizations for atrial fibrillation, 61,305 (22.1%) occurred on weekends. Weekend admissions were less likely to undergo cardioversion (19.0% vs 22.0%; aOR 0.83, 95% CI 0.79-0.88; p < 0.001). In-hospital mortality was similar in weekend admissions (1.0%) compared to weekdays (0.8%) with an adjusted odds ratio (aOR) of 1.21 (95% CI 0.97-1.52; p = 0.090). Hospital charges were lower among weekend admissions ($48,478 vs $50,588; p = 0.022). There were no significant differences in length of stay (3.59 vs 3.58 days; p = 0.545) between groups.
conclusionsWeekend admissions for atrial fibrillation are less likely to undergo cardioversion. There was no significant difference in in-hospital mortality or length of stay. This pattern may reflect differences in care delivery or patient selection by day of admission, although the underlying mechanism cannot be determined using administrative data.
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