Is there a "weekend effect" in emergency general surgery?
<h4>Background</h4> <p>Weekend admission is associated with increased mortality across a range of patient populations and healthcare systems. The aim of this study was to determine whether weekend admission is independently associated with serious adverse events (SAE), in-hospital...
| Main Authors: | , , , , , |
|---|---|
| Format: | Journal article |
| Published: |
Elsevier
2017
|
| _version_ | 1826264736608550912 |
|---|---|
| author | Metcalfe, D Castillo-Angeles, M Ríos-Diaz, AJ Havens, JM Haider, A Salim, A |
| author_facet | Metcalfe, D Castillo-Angeles, M Ríos-Diaz, AJ Havens, JM Haider, A Salim, A |
| author_sort | Metcalfe, D |
| collection | OXFORD |
| description | <h4>Background</h4> <p>Weekend admission is associated with increased mortality across a range of patient populations and healthcare systems. The aim of this study was to determine whether weekend admission is independently associated with serious adverse events (SAE), in-hospital mortality, or failure to rescue (FTR) in emergency general surgery (EGS).</p> <h4>Methods</h4> <p>An observational study using the National Inpatient Sample (NIS) 2012-2013; the largest all-payer inpatient database in the United States, which represents a 20% stratified sample of hospital discharges. The inclusion criteria were all inpatients with a primary EGS diagnosis. Outcomes were SAE, in-hospital mortality, and FTR (in-hospital mortality in the population of patients that developed an SAE). Logistic multivariable regression models were used to adjust for patient- (age, sex, race, payer status, Charlson comorbidity index) and hospital-level (trauma designation, hospital bed size) characteristics.</p> <h4>Results</h4> <p>There were 1,344,828 individual patient records (6.7 million weighted admissions). The overall rate of SAE was 15.1% (15.1% weekend, 14.9% weekday, p<0.001), FTR 5.9% (6.2% weekend, 5.9% weekday, p=0.010), and in-hospital mortality 1.4% (1.5% weekend, 1.3% weekday, p<0.001). Within logistic regression models, weekend admission was an independent risk factor for development of SAE (aOR 1.08, 1.07-1.09), FTR (1.05, 1.01-1.10), and in-hospital mortality (1.14, 1.10-1.18).</p> <h4>Conclusion</h4> <p>This study found evidence that outcomes coded in an administrative dataset are marginally worse for EGS patients admitted at weekends. This justifies further work using clinical datasets that can be used to better control for differences in case mix.</p> |
| first_indexed | 2024-03-06T20:12:39Z |
| format | Journal article |
| id | oxford-uuid:2b176256-a855-42f9-8ccc-4236bec56411 |
| institution | University of Oxford |
| last_indexed | 2024-03-06T20:12:39Z |
| publishDate | 2017 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:2b176256-a855-42f9-8ccc-4236bec564112022-03-26T12:29:01ZIs there a "weekend effect" in emergency general surgery?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:2b176256-a855-42f9-8ccc-4236bec56411Symplectic Elements at OxfordElsevier2017Metcalfe, DCastillo-Angeles, MRíos-Diaz, AJHavens, JMHaider, ASalim, A <h4>Background</h4> <p>Weekend admission is associated with increased mortality across a range of patient populations and healthcare systems. The aim of this study was to determine whether weekend admission is independently associated with serious adverse events (SAE), in-hospital mortality, or failure to rescue (FTR) in emergency general surgery (EGS).</p> <h4>Methods</h4> <p>An observational study using the National Inpatient Sample (NIS) 2012-2013; the largest all-payer inpatient database in the United States, which represents a 20% stratified sample of hospital discharges. The inclusion criteria were all inpatients with a primary EGS diagnosis. Outcomes were SAE, in-hospital mortality, and FTR (in-hospital mortality in the population of patients that developed an SAE). Logistic multivariable regression models were used to adjust for patient- (age, sex, race, payer status, Charlson comorbidity index) and hospital-level (trauma designation, hospital bed size) characteristics.</p> <h4>Results</h4> <p>There were 1,344,828 individual patient records (6.7 million weighted admissions). The overall rate of SAE was 15.1% (15.1% weekend, 14.9% weekday, p<0.001), FTR 5.9% (6.2% weekend, 5.9% weekday, p=0.010), and in-hospital mortality 1.4% (1.5% weekend, 1.3% weekday, p<0.001). Within logistic regression models, weekend admission was an independent risk factor for development of SAE (aOR 1.08, 1.07-1.09), FTR (1.05, 1.01-1.10), and in-hospital mortality (1.14, 1.10-1.18).</p> <h4>Conclusion</h4> <p>This study found evidence that outcomes coded in an administrative dataset are marginally worse for EGS patients admitted at weekends. This justifies further work using clinical datasets that can be used to better control for differences in case mix.</p> |
| spellingShingle | Metcalfe, D Castillo-Angeles, M Ríos-Diaz, AJ Havens, JM Haider, A Salim, A Is there a "weekend effect" in emergency general surgery? |
| title | Is there a "weekend effect" in emergency general surgery? |
| title_full | Is there a "weekend effect" in emergency general surgery? |
| title_fullStr | Is there a "weekend effect" in emergency general surgery? |
| title_full_unstemmed | Is there a "weekend effect" in emergency general surgery? |
| title_short | Is there a "weekend effect" in emergency general surgery? |
| title_sort | is there a weekend effect in emergency general surgery |
| work_keys_str_mv | AT metcalfed isthereaweekendeffectinemergencygeneralsurgery AT castilloangelesm isthereaweekendeffectinemergencygeneralsurgery AT riosdiazaj isthereaweekendeffectinemergencygeneralsurgery AT havensjm isthereaweekendeffectinemergencygeneralsurgery AT haidera isthereaweekendeffectinemergencygeneralsurgery AT salima isthereaweekendeffectinemergencygeneralsurgery |