Influence of weekend versus weekday hospital admission on mortality following subarachnoid hemorrhage

Clinical article

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  • 1 Departments of Neurosurgery;
  • 2 Radiology, and
  • 3 Public Health Sciences, University of Virginia Health System, Charlottesville, Virginia
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Object

Several studies have indicated that short-term mortality risk is higher among patients who are admitted on the weekends. This “weekend effect” has been observed among patients admitted with a variety of diagnoses, including myocardial infarction, pulmonary embolism, ruptured abdominal aortic aneurysm, and stroke. This study examines the relationship between short-term mortality risk and weekend admission among patients hospitalized following subarachnoid hemorrhage (SAH).

Methods

This retrospective cohort study examines mortality outcomes among patients included in the Nationwide Inpatient Sample (NIS) for 2004. Patients included in the cohort were identified using the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) code for SAH. Multivariable logistic regression analyses and Cox proportional hazard regression analyses are used to measure the association of weekend admission on mortality for patients with SAH, adjusted for differences in patient characteristics that also contribute to mortality risk.

Results

Weekend admissions occurred among 27.5% of the 5667 patients with SAH in the NIS database. Weekend admission was not a statistically significant independent predictor of death in the SAH study population at 7 days (OR 1.07, 95% CI 0.91–1.25), 14 days (OR 1.01, 95% CI 0.87–1.17), or 30 days (OR 1.03, 95% CI 0.89–1.19).

Conclusions

Weekend admission is not associated with significantly increased short-term mortality risk among patients hospitalized with SAH.

Abbreviations used in this paper: HR = hazard ratio; ICU = intensive care unit; SAH = subarachnoid hemorrhage.

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Contributor Notes

Address correspondence to: Aaron S. Dumont, M.D., Box 800212, Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia 22908. email: asd2f@virginia.edu.
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