Is there a weekend effect on mortality rate and outcome for moderate and severe traumatic brain injury? A population-based, observational cohort study

Purpose: The aim of the study was to analyse patient and injury characteristics and the effects of weekend admissions on mortality rate and outcome after moderate and severe traumatic brain injuries. Methods: This is an observational cohort study based on data from a prospectively maintained regiona...

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Main Authors: Joakim Stray Andreassen, Kenneth Thorsen, Kjetil Søreide, David Werner, Clemens Weber
Format: Article
Language:English
Published: Elsevier 2022-01-01
Series:Brain and Spine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2772529422008402
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author Joakim Stray Andreassen
Kenneth Thorsen
Kjetil Søreide
David Werner
Clemens Weber
author_facet Joakim Stray Andreassen
Kenneth Thorsen
Kjetil Søreide
David Werner
Clemens Weber
author_sort Joakim Stray Andreassen
collection DOAJ
description Purpose: The aim of the study was to analyse patient and injury characteristics and the effects of weekend admissions on mortality rate and outcome after moderate and severe traumatic brain injuries. Methods: This is an observational cohort study based on data from a prospectively maintained regional trauma registry in South Western Norway. Patients with moderate and severe traumatic brain injury admitted between January 1st, 2004 and December 31st, 2019 were included in this study. Results: During the study period 688 patients were included in the study with similar distribution between moderate (n ​= ​318) and severe (n ​= ​370) traumatic brain injury. Mortality rate was 46% in severe and 13% in moderate traumatic brain injury. Two hundred and thirty-one (34%) patients were admitted during weekends. Patients admitted during weekends were significantly younger (median age (IQR) 32.0 (25.5–67.0) vs 47.0 (20.0–55.0), p ​< ​0.001). Pre-injury ASA 1 was significantly more common in patients admitted during weekends (n ​= ​146, 64%, p ​= ​0.001) while ASA 3 showed significance during weekdays compared to weekends (n ​= ​101, 22%, p ​= ​0.013). On binominal logistic regression analysis mortality rate was significantly higher with older age (OR 1.03, 95% CI for OR 1.02–1.04, p ​< ​0.001) and increasing TBI severity (OR 7.08, 95% CI for OR 4.67–10.73, p ​< ​0.001). Conclusions: Mortality rate and poor clinical outcome remain high in severe traumatic brain injury. While a higher number of patients are admitted during the weekend, mortality rate does not differ from weekday admissions.
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spelling doaj.art-f6ddf343a29c445e80ebae73d113e8792022-12-25T04:20:55ZengElsevierBrain and Spine2772-52942022-01-012101699Is there a weekend effect on mortality rate and outcome for moderate and severe traumatic brain injury? A population-based, observational cohort studyJoakim Stray Andreassen0Kenneth Thorsen1Kjetil Søreide2David Werner3Clemens Weber4Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway; Corresponding author. Department of Neurosurgery, St. Olavs University Hospital , Postboks 3250 Torgarden, 7006, Trondheim, Norway.Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, The Faculty of Medicine, University of Bergen, Bergen, Norway; Section for Traumatology, Surgical Clinic, Stavanger University Hospital, Stavanger, NorwayDepartment of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, The Faculty of Medicine, University of Bergen, Bergen, NorwayDepartment of Neurosurgery, Stavanger University Hospital, Stavanger, NorwayDepartment of Neurosurgery, Stavanger University Hospital, Stavanger, Norway; Department of Quality and Health Technology, University of Stavanger, Stavanger, NorwayPurpose: The aim of the study was to analyse patient and injury characteristics and the effects of weekend admissions on mortality rate and outcome after moderate and severe traumatic brain injuries. Methods: This is an observational cohort study based on data from a prospectively maintained regional trauma registry in South Western Norway. Patients with moderate and severe traumatic brain injury admitted between January 1st, 2004 and December 31st, 2019 were included in this study. Results: During the study period 688 patients were included in the study with similar distribution between moderate (n ​= ​318) and severe (n ​= ​370) traumatic brain injury. Mortality rate was 46% in severe and 13% in moderate traumatic brain injury. Two hundred and thirty-one (34%) patients were admitted during weekends. Patients admitted during weekends were significantly younger (median age (IQR) 32.0 (25.5–67.0) vs 47.0 (20.0–55.0), p ​< ​0.001). Pre-injury ASA 1 was significantly more common in patients admitted during weekends (n ​= ​146, 64%, p ​= ​0.001) while ASA 3 showed significance during weekdays compared to weekends (n ​= ​101, 22%, p ​= ​0.013). On binominal logistic regression analysis mortality rate was significantly higher with older age (OR 1.03, 95% CI for OR 1.02–1.04, p ​< ​0.001) and increasing TBI severity (OR 7.08, 95% CI for OR 4.67–10.73, p ​< ​0.001). Conclusions: Mortality rate and poor clinical outcome remain high in severe traumatic brain injury. While a higher number of patients are admitted during the weekend, mortality rate does not differ from weekday admissions.http://www.sciencedirect.com/science/article/pii/S2772529422008402EpidemiologyTraumatic brain injuryMortalityWeekend
spellingShingle Joakim Stray Andreassen
Kenneth Thorsen
Kjetil Søreide
David Werner
Clemens Weber
Is there a weekend effect on mortality rate and outcome for moderate and severe traumatic brain injury? A population-based, observational cohort study
Brain and Spine
Epidemiology
Traumatic brain injury
Mortality
Weekend
title Is there a weekend effect on mortality rate and outcome for moderate and severe traumatic brain injury? A population-based, observational cohort study
title_full Is there a weekend effect on mortality rate and outcome for moderate and severe traumatic brain injury? A population-based, observational cohort study
title_fullStr Is there a weekend effect on mortality rate and outcome for moderate and severe traumatic brain injury? A population-based, observational cohort study
title_full_unstemmed Is there a weekend effect on mortality rate and outcome for moderate and severe traumatic brain injury? A population-based, observational cohort study
title_short Is there a weekend effect on mortality rate and outcome for moderate and severe traumatic brain injury? A population-based, observational cohort study
title_sort is there a weekend effect on mortality rate and outcome for moderate and severe traumatic brain injury a population based observational cohort study
topic Epidemiology
Traumatic brain injury
Mortality
Weekend
url http://www.sciencedirect.com/science/article/pii/S2772529422008402
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