Influence of Weekend Hospital Admission on Short-Term Mortality After Intracerebral Hemorrhage
- 1 July 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 40 (7), 2387-2392
- https://doi.org/10.1161/strokeaha.108.546572
Abstract
Background and Purpose— There is expanding literature to show that certain patients admitted during the weekend have worse outcomes than similar patients admitted during the week. Although many clinicians have hypothesized the presence of this “weekend effect” with patients with intracerebral hemorrhage, there is a paucity of studies validating this conjecture. Methods— We performed a retrospective cohort study of patients with intracerebral hemorrhage (International Classification of Diseases, 9th Revision, Clinical Modification=431) extracted from the 2004 Nationwide Inpatient Sample. Multivariable logistic regression analyses and Cox proportional hazards regression were conducted to calculate the odds of death (within 7, 14, and 30 days) and the hazard ratio of death for patients with weekend intracerebral hemorrhage admissions compared with weekday intracerebral hemorrhage admissions. All analyses were adjusted for concurrent differences in length of stay, patient demographics, and comorbid disease. Results— Weekend hospital admissions accounted for 26.8% of the 13 821 patients with a diagnosis of intracerebral hemorrhage in the National Inpatient Sample. Admission during the weekend was a statistically significant independent predictor of death within 7 days (OR, 1.14; 95% CI, 1.05 to 1.25), within 14 days (OR, 1.15; 95% CI, 1.05 to 1.25), and within 30 days (OR, 1.15; 95% CI, 1.05 to 1.25). The adjusted hazard of in-hospital death (hazard ratio, 1.12; CI, 1.05 to 1.20) indicates that the overall risk of in-hospital death with intracerebral hemorrhage is 12% higher with weekend admission. Conclusion— Weekend admission for intracerebral hemorrhage was associated with increased risk-adjusted mortality when compared with admission during the remainder of the week.This publication has 31 references indexed in Scilit:
- Survival From In-Hospital Cardiac Arrest During Nights and WeekendsJAMA, 2008
- Weekend Versus Weekday Admission and Stroke Outcome in Sweden From 1968 to 2005Stroke, 2007
- Changes in Cost and Outcome Among US Patients With Stroke Hospitalized in 1990 to 1991 and Those Hospitalized in 2000 to 2001Stroke, 2007
- Weekends: A Dangerous Time for Having a Stroke?Stroke, 2007
- Weekend versus Weekday Admission and Mortality from Myocardial InfarctionThe New England Journal of Medicine, 2007
- The Effect of Weekends and Holidays on Stroke Outcome in Acute Stroke UnitsCerebrovascular Diseases, 2005
- Do weekends or evenings matter in a pediatric intensive care unit?*Pediatric Critical Care Medicine, 2005
- Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the International Surgical Trial in Intracerebral Haemorrhage (STICH): a randomised trialThe Lancet, 2005
- The Hospital Mortality of Patients Admitted to the ICU on WeekendsSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2004
- Outcomes after cerebral aneurysm clip occlusion in the United States: the need for evidence-based hospital referralJournal of Neurosurgery, 2003