We’ve done multiple columns on the fact that there are dangers on weekends in most hospitals that go above and beyond those present on weekdays or even weekday nights.
Yet another study (Barba 2011) demonstrates increased mortality for patients admitted on weekends - this time for patients with COPD exacerbations. The authors looked at survival of COPD patients admitted to Spanish hospitals. Case fatality rates were significantly higher for those COPD patients admitted on weekends (12.9% vs. 12.1%) and when they analyzed deaths within 48 hours and 24 hours of admission, those admitted on weekends had a 17% and 39% higher risk, respectively.
In our June 2011 What’s New in the Patient Safety World “Another Study on Dangers of Weekend Admissions” we noted a study (Ricciardi 2011) that came to similar conclusions about mortality for a variety of conditions. The authors studied nonelective hospital admissions in a large all-payor database and analyzed data by day of the week admitted. They found that mortality rates were higher for 15 of 26 major diagnostic categories when patients were admitted on weekends. Even after adjustment for comorbidities and a variety of other clinical and demographic characteristics there remained a significant increase in mortality, on the order of 10% higher for those admitted on weekends. The major diagnostic category of “respiratory” in that study did also show higher weekend mortality rates.
We’ve discussed the numerous factors that may contribute to the “weekend effect” in our previous columns:
Barba R, Zapatero A, Losa JE, et al. The impact of weekends on outcome for Acute Exacerbations of COPD. Eur Respir J erj00132-2011; published ahead of print 2011
Ricciardi R, Roberts PL, Read TE, et al. Mortality Rate After Nonelective Hospital Admission. Arch Surg. 2011; 146(5): 545-551