Single-Center Analysis of the Off-Hour Effect in Cardiogenic Shock Outcomes

The off-hours effect is a phenomenon where patients admitted during nights and weekends have poorer outcomes than those admitted during weekdays. This observation is often more pronounced in emergent conditions such as cardiogenic shock. Few studies have investigated the presence of an off-hour effect in patients with cardiogenic shock. In my thesis project, I explored the existence of an off-hour effect in 155 cardiogenic shock cases at a major urban hospital by evaluating patient outcomes. Patients admitted during off-hours had higher complication rates (OR=2.66, 95% CI, 1.29 to 5.49; p=0.01). I also found that patients admitted during on-hours waited longer to receive mechanical circulatory support devices after being admitted; however, this did not appear to negatively effect on-hour patient outcomes. While it appears that admission time does influence patient outcomes, the underlying cause for this effect is not yet understood.