TY - JOUR
T1 - Impact of weekend admission on mortality and other outcomes among patients with burn injury
T2 - A nationwide analysis
AU - Peluso, Heather
AU - Abougergi, Marwan S.
AU - Caffrey, Julie
N1 - Publisher Copyright:
© 2017 Elsevier Ltd and ISBI
PY - 2017/12
Y1 - 2017/12
N2 - 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.
AB - 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.
KW - Burn injury
KW - Mortality
KW - Outcomes
KW - Resource utilization
KW - Weekend
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U2 - 10.1016/j.burns.2017.08.005
DO - 10.1016/j.burns.2017.08.005
M3 - Article
C2 - 28927832
AN - SCOPUS:85029541273
SN - 0305-4179
VL - 43
SP - 1654
EP - 1661
JO - Burns
JF - Burns
IS - 8
ER -