Impact of weekend admission on mortality and other outcomes among patients with burn injury: A nationwide analysis

Heather Peluso, Marwan S. Abougergi, Julie Caffrey

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Abstract

Objective: To study the relationship between day of admission and important outcomes among patients with burn injuries. Methods: The 2014 National Inpatient Sample database was used. Inclusion criterion was a principal diagnosis of burn injury. Exclusion criteria were age <18. years, superficial burn, and non-urgent admission. The primary outcome was in-hospital mortality. Secondary outcomes were morbidity (septic shock and prolonged mechanical ventilation), treatment metrics (time to surgery and parenteral or enteral nutrition (P/E-nutrition)) and resource utilization (length of stay (LOS) and total hospitalization charges and costs). Confounders were adjusted for using multivariate regression analysis. Results: A total of 21,665 patients were included, 29% of whom were admitted on weekends. Weekend admission was an independent predictor of mortality only among patients >65. years old (adjusted odds ratio (aOR): 2.66 (1.13-4.51), p = 0.02). Although rates of septic shock were similar for both groups (aOR): 1.25 (0.74-2.09, p = 0.40), weekends were associated with higher odds of prolonged mechanical ventilation (aOR: 1.28 (1.06-1.55), p = 0.01). Time to surgery (adjusted mean difference (amDiff): 0.91 (-0.07 to 1.88) days, p = 0.07) and time to P/E-nutrition (amDiff: 0.40 (-3.51 to 4.30) days, p = 0.80) were similar for both groups. Finally, LOS was longer for weekend admission (amDiff: 1.36 (0.09-2.63) days, p = 0.04), but total charges and costs were similar for both groups (amDiff: $16,268 ($-5093-$37,629), p = 0.13 and $3275 ($-2337-$8888), p = 0.25). Conclusions: Weekend admission is associated with increased mortality among patients with burn injury >65. years old. Weekend admission is also associated with increased morbidity and prolonged length of stay.

Original languageEnglish (US)
JournalBurns
DOIs
StateAccepted/In press - 2017

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Keywords

  • Burn injury
  • Mortality
  • Outcomes
  • Resource utilization
  • Weekend

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

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