The effect of the day of the week of discharge on mortality and readmissions in patients hospitalized due to heart failure

Background: The effect of the day of the week of discharge on mortality and readmissions in patients hospitalized due to heart failure (HF) remains unclear. The aim was to determine the effect of the day of the week of discharge of HF patients on 30-day and one-year mortality and rehospitalizations. Material and methods: Inclusion criteria were hospitalization due to HF exacerbation in the 2013 year according to the National Health Fund data. The primary outcome variable was all-cause mortality and the secondary the first readmission due to HF exacerbation. Survival analysis was performed for outcomes according to the day of the week of discharge adjusting for age, sex, duration of the hospitalization, HF severity, type of ward, and fulfilling prescription for selected medications within the 30-day post-hospitalization period. Results: The analysis included 96,219 patients (median age 77.0 yrs., 46.3% males). The mean all-cause one-year mortality was the highest on Sundays when compared with other days separately in the Cox analysis [hazard ratio (HR): 1.40; 95% confidence interval (CI): 1.23–1.59; p < 0.001] and also when compared with the other weekdays pulled (27.8% vs. 21.8%, p < 0.001). The 30-day mortality was the highest for Sunday discharges in the Cox analysis (HR: 2.14; 95% CI: 1.78–2.57; p < 0.001). The day of the week of discharge did not affect rehospitalization rates. Conclusions: The day of the week of discharge of HF patients matters as it may be related to the prognosis.