Abstract 19854: A National Perspective of Weekend- Effect on Mortality and Adverse Outcomes in Patients with Intracerebral Hemorrhage
Introduction: Management of intracerebral hemorrhage (ICH) requires urgent diagnostic and therapeutic procedures, which may not be uniformly available throughout the week. We attempt to define a "weekend effect" for ICH, which has not yet been fully established in this patient population.
Hypothesis: We aimed to evaluate whether outcomes differ with respect to the day of admission in patients admitted with ICH.
Methods: We reviewed the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (NIS) database from 2000 to 2011 for ICH using ICD 9-CM codes. NIS represents 20% of all US hospital pts and weighted numbers represent national estimates.We defined primary outcome as mortality and adverse outcome(composite of in-hospital mortality & discharge other than home). We utilized chi-square test for univariable analysis for categorical variables and generated hierarchical multilevel regression models to determine independent predictors of mortality and adverse outcome.
Results: We included 161017 patients (weighted n=788641) with ICH, out of which 42996(weighted n= 210592) were admitted on weekend. After adjusting for confounders (demographics, Deyo’s modification of charlson’s co-morbidity index, admission type (elective or emergent), hospital region, hospital teaching status, hospital ICH volume and primary payer), the weekend admissions were still associated with 10 % higher mortality (OR 1.10, 95% CI 1.07-1.16, P=0.001) and 20% higher adverse outcome (OR 1.12, 95% CI 1.09-1.16, p=0.001).
Conclusions: Thus, admission for ICH on the weekend was a significant and independent predictor of increased in hospital mortality and adverse outcomes as compared to weekday admission. The reasons for this are likely manifold and warrant further investigation both from a quantitative and qualitative standpoint.
Author Disclosures: A. Patel: None. G. Nadkarni: None. N. Patel: None. S. Lahewala: None. S. Busani: None. S. Solanki: None. G. Dhaduk: None. C. Bambhroliya: None. A. Mahajan: None. P. Simoes: None. I. Konstantinidis: None. Y. Gujarati: None. A.M. Benjo: None. V. Jani: None. A. Badheka: None. S.I. Hussain: None.
- © 2014 by American Heart Association, Inc.