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Weekends More Fatal for Older Patients With Head Injury: Study
Death risk rose when hospital admission occured on Saturday, Sunday
Tuesday, August 7, 2012
Weekend hospital stays proved more deadly even for patients with less serious injuries, the Johns Hopkins researchers noted. They suggested that reduced staffing or fewer available specialists on the weekends might play a role in the higher death rates.
"There isn't a medical reason for worse results on weekends," study leader Eric Schneider, an epidemiologist at the Johns Hopkins University School of Medicine's Center for Surgical Trials and Outcomes Research, said in a Hopkins news release. "It's more likely a difference in how hospitals operate over the weekend as opposed to during the week, meaning that there may be a real opportunity for hospitals to change how they operate and save lives."
In conducting the study, the researchers examined the hospital records of over 38,000 patients aged 65 to 89 who were admitted to the hospital with head trauma in 2006 through 2008. Of these, about one-quarter of the admissions occurred on a weekend.
The investigators found that older adults who were admitted over the weekend due to serious head trauma were 14 percent more likely to die from their injuries than older adults admitted Monday through Friday for the same reason. The study also found that older patients admitted on the weekend with less severe head injuries were still more likely to die than patients admitted during the week, even if the weekend patients were in better overall health.
The researchers pointed out that the cost of care for weekend patients was similar to that of weekday patients, suggesting they received similar treatments. However, the timing of the treatment each patient received could not be determined.
In addition, from the data they analyzed, the investigators could not differentiate between the patients seen at trauma centers and those admitted to teaching hospitals or community hospitals. They noted, however, previous research has shown the "weekend effect" is reduced for patients taken to Level 1 trauma centers staffed 24 hours a day by highly trained specialists.
The researchers pointed out that 1.4 million Americans sustain head injuries that send them to the hospital each year, and risk for this type of injury increases as people age. People over 75 account for most hospitalizations and deaths associated with head trauma, the authors noted in the news release.
The study authors concluded that one solution to the "weekend effect" is for hospitals to keep the same level of staffing on the weekend as they do during the week, but they noted this may be too costly for many hospitals. In these cases, older patients who sustain head injuries during the weekend should be taken directly to the nearest trauma center.
The findings were published online in the Journal of Surgical Research.
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