What’s New in the Patient Safety World
September 2011
Add COPD to Perilous Weekends
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:
- February 26, 2008 Patient Safety Tip of the Week “Nightmares….The Hospital at Night”
- December 15, 2009 Patient Safety Tip of the Week “The Weekend Effect”
- July 20, 2010 Patient Safety Tip of the Week “More on the Weekend Effect/After-Hours Effect”
- October 2008 What’s New in the Patient Safety World “Hospital at Night Project”
- September 2009 What’s New in the Patient Safety World “After-Hours Surgery – Is There a Downside?”
- December 21, 2010 Patient Safety Tip of the Week “More Bad News About Off-Hours Care”
- June 2011 What’s New in the Patient
Safety World “Another
Study on Dangers of Weekend Admissions”
Reference:
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
http://archsurg.ama-assn.org/cgi/content/short/146/5/545
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