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'Weekend Effect': What Is the Evidence?

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'Weekend Effect': What Is the Evidence? The 'weekend effect': What is the evidence? 1st June 2016 Paul Aylin Professor of Epidemiology and Public Health [email protected] Imperial Patient Safety Translational Research Centre The ‘weekend effect’ • Background • My work • Explanations • Next steps Freemantle et al. • Update of their 2012 paper on 2009/10 admissions for 2013/14 • Compared with Wednesday • Combines elective and emergency admissions • Choice of disease specific analyses (Oncology and cardiovascular) • Day of death analysis 1. Abougergi MS, Travis AC, Saltzman JR. Impact of day of admission on Increased mortality associated with weekend hospital admission: a case for 68. O'Neill DE, Southern DA, O'Neill BJ, McMurtry MS, Graham MM. Weekend mortality and other outcomes in upper GI hemorrhage: a nationwide analysis. expanded 7 day services? BMJ 2015;351 :h4596 compared with weekday presentation does not affect outcomes of patients Gastrointest Endosc. 2014 Aug; 80(2): 228-35 presenting with non-ST elevation acute coronary syndrome. Eur Heart J 35. Freemantle, Keogh, Pagano et al. Weekend hospitalization and additional http://www.ncbi.nlm.nih.gov/pubmed/24674354 Acute Cardiovasc Care. 2014 Jun; 3(2): 99-104. risk of death: An analysis of inpatient data. N J R Soc Med 2012; 105(2): 74- http://www.ncbi.nlm.nih.gov/pubmed/24585942 2. Albright KC, Savitz SI, Raman R, Martin-Schild S, Broderick J, Ernstrom K, 84 http://www.ncbi.nlm.nih.gov/pubmed/22307037 Ford A, Khatri R, Kleindorfer D, Liebeskind D, Marshall R, Merino JG, Meyer 69. Orandi BJ, Selvarajah S, Orion KC, Lum YW, Perler BA, Abularrage CJ. 36. Gallerani M, Imberti D, Ageno W, Dentali F, Manfredini R. Higher mortality DM, Rost N, Meyer BC. Comprehensive stroke centers and the 'weekend Outcomes of nonelective weekend admissions for lower extremity ischemia. J rate in patients hospitalised for acute pulmonary embolism during weekends. effect': the SPOTRIAS experience. Cerebrovasc Dis. 2012; 34(5-6): 424-9 Vasc Surg. 2014 Dec; 60(6): 1572-9 Thromb Haemost. 2011 Jul; 106(1): 83-9 http://www.ncbi.nlm.nih.gov/pubmed/23207423 http://www.ncbi.nlm.nih.gov/pubmed/25441678 http://www.ncbi.nlm.nih.gov/pubmed/21544321 3. Al-Lawati JA, Al-Zakwani I, Sulaiman K, Al-Habib K, Al Suwaidi J, 70. Orman ES, Hayashi PH, Dellon ES, Gerber DA, Barritt AS 4th. Impact of 37. Gellerani M et al. Aortic rupture. Journal of Vascular Surgery. Volume 55, Panduranga P, Alsheikh-Ali AA, Almahmeed W, Al Faleh H, Al Saif S, Hersi nighttime and weekend liver transplants on graft and patient outcomes. Liver Issue 5 , Pages 1247-1254, May 2012. Higher mortality in patients A, Asaad N, Al-Motarreb A,Over Mikhailidis DP, Amin 100 H. Weekend papers versus Transpl. 2012 May; 18(5): 558-65 hospitalized for acute aortic rupture or dissection during weekends weekday, morning versus evening admission in relationship to mortality in http://www.ncbi.nlm.nih.gov/pubmed/22271668 http://www.ncbi.nlm.nih.gov/pubmed/22542339 acute coronary syndrome patients in 6 middle eastern countries: results from 71. Ozdemir BA, Sinha S, Karthesalingham, Poloniecki J, Pearse RM, Grocott gulf race 2 registry. Open Cardiovasc Med J. 2012; 6: 106-12 38. Goldacre MJ, Maisonneuve JJ. Mortality from meningococcal disease by day MPW, Thompson MM, Holt P. Mortality of emergency general surgical http://www.ncbi.nlm.nih.gov/pubmed/23002404 of the week: English national linked database study J Public Health (Oxf). patients and associations with hospital structures and processes. British 2013 Sep; 35(3): 413-21 http://www.ncbi.nlm.nih.gov/pubmed/23378233 4. Ananthakrishnan AN et al. Outcomes of Weekend Admissions for Upper Journal of Anaesthesia 2016;116 (1):54-62 Gastrointestinal Hemorrhage: A Nationwide Analysis. Clin Gastro Hepatology 39. Goldstein SD, Papandria DJ, Aboagye J, Salazar JH, Van Arendonk K, Al- 72. Palmer W, Bottle A, Aylin P. Association between day of delivery and obstetric 2009; 7(3): 296-302.e1 http://www.ncbi.nlm.nih.gov/pubmed/19084483 Omar K, Ortega G, Sacco Casamassima MG, Abdullah F. The "weekend outcomes: observational study. BMJ 2015;351:h5774 effect" in pediatric surgery - increased mortality for children undergoing urgent 5. Arabi Y, Alshimemeri A, Taher S.. Weekend and weeknight admissions have surgery during the weekend. J Pediatr Surg. 2014 Jul; 49(7): 1087-91. 73. Palmer WL et al. A Retrospective Cohort Study on the Association Between the same outcome of weekday admissions to an intensive care unit with http://www.ncbi.nlm.nih.gov/pubmed/24952794 Day of Hospital Presentation and the Quality and Safety of Stroke Care. Arch onsite intensivist coverage. Crit Care Med. 2006 Mar; 34(3): 605-11 Neurol 2012; 69(10): 1296-1302 http://www.ncbi.nlm.nih.gov/pubmed/16521254 40. Goodman EK, Reilly AF, Fisher BT, Fitzgerald J, Li Y, Seif AE, Huang YS, http://www.ncbi.nlm.nih.gov/pubmed/22777008 Bagatell R, Aplenc R. Association of weekend admission with hospital length 6. Aylin P et al. Day of week of procedure and 30 day mortality for elective of stay, time to chemotherapy, and risk for respiratory failure in pediatric 74. Pasupathy D, Wood AM, Pell JP, Fleming M, Smith GC. Time of birth and risk surgery: retrospective analysis of hospital episode statistics.. BMJ 2013; 346: patients with newly diagnosed leukemia at freestanding US children's of neonatal death at term: retrospective cohort study. BMJ 2010;341:c3498. f2424 http://www.ncbi.nlm.nih.gov/pubmed/23716356 hospitals. JAMA Pediatr. 2014 Oct; 168(10): 925-31 75. Pederby MA et al. Survival From In-Hospital Cardiac Arrest During Nights 7. Aylin P et al. Weekend mortality for emergency admissions. A large, http://www.ncbi.nlm.nih.gov/pubmed/25155012 and Weekends. JAMA 2008; 299(7): 785-792 multicentre study. Qual Saf Health Care 2010; 19(3): 213-217 41. Groves EM, Khoshchehreh M, Le C, Malik S. Effects of weekend admission http://www.ncbi.nlm.nih.gov/pubmed/18285590 http://www.ncbi.nlm.nih.gov/pubmed/20110288 on the outcomes and management of ruptured aortic aneurysms. J Vasc 76. Powell ES, Khare RK, Courtney DM, Feinglass J. The weekend effect for 8. Barba R et al. The impact of weekends on outcome for acute exacerbations of Surg. 2014 Aug; 60(2): 318-24 patients with sepsis presenting to the emergency department . J Emerg Med. COPD. ERJ 2012; 39(1): 46-50 http://www.ncbi.nlm.nih.gov/pubmed/24709439 2013 Nov;45(5):641-8. doi: 10.1016/j.jemermed.2013.04.042. Epub 2013 Aug http://www.ncbi.nlm.nih.gov/pubmed/21659418 42. Hamaguchi S, Kinugawa S, Tsuchihashi-Makaya M, Goto D, Tsutsui H. 30. http://www.ncbi.nlm.nih.gov/pubmed/23993937 9. Barnett MJ et al. Day of the week of intensive care admission and patient Weekend versus weekday hospital admission and outcomes during 77. Ricciardi R, Nelson J, Roberts PL, Marcello PW, Read TE, Schoetz DJ. Is the outcomes: a multisite regional evaluation. Med Care 2002; 40(6): 530-9 hospitalization for patients due to worsening heart failure: a report from presence of medical trainees associated with increased mortality with http://www.ncbi.nlm.nih.gov/pubmed/12021679 Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD). weekend admission? BMC Med Educ. 2014 Jan 8;14:4. doi: 10.1186/1472- Heart Vessels. 2014 May; 29(3): 328-35 10. Bejanyan N, Fu AZ, Lazaryan A, Fu R, Kalaycio M, Advani A, Sobecks R, 6920-14-4 http://www.ncbi.nlm.nih.gov/pubmed/24397268 http://www.ncbi.nlm.nih.gov/pubmed/23653107 Copelan E, Maciejewski JP, Sekeres MA. Impact of weekend admissions on 78. Robinson E, Smith G, Power S, Harrison D, Nolan J, Soar J, Spearpoint K, quality of care and outcomes in patients with acute myeloid leukemia Cancer. 43. Hamilton P et al. Weekend Birth and Higher Neonatal Mortality: A Problem of Gwinnutt C, Rowan K. Risk-adjusted survival for adults following in-hospital 2010 Aug 1; 116(15): 3614-20 http://www.ncbi.nlm.nih.gov/pubmed/20564070 Patient Acuity or Quality of Care? Journal of Obstetric, Gynecologic, & cardiac arrest by day of week and time of day: observational cohort study. Neonatal Nursing 2003; 32(6): 724–733 11. Béjot Y, Aboa-Eboulé C, Jacquin A, Troisgros O, Hervieu M, Durier J, Osseby BMJ Qual Saf 2015. http://dx.d http://www.ncbi.nlm.nih.gov/pubmed/14649592 GV, Giroud M. Eur J Neurol. Stroke care organization overcomes the 79. Ruiz M, Bottle A, Aylin P. The Global Comparators Project: international deleterious 'weekend effect' on 1-month stroke mortality: a population-based 44. Handel EH et al. Weekend admissions as an independent predictor of comparison of 30 day in-hospital mortality by day of the week. BMJ Quality study. 2013 Aug; 20(8): 1177-83 mortality: an analysis of Scottish hospital admissions. BMJ Open 2012; 2: and Safety 2015;0:1-13 doi:10.1136/bmjqs-2014-003467 http://www.ncbi.nlm.nih.gov/pubmed/23551852 e001789 http://www.ncbi.nlm.nih.gov/pubmed/23135542 80. Sakhuja A et al. Outcomes of Patients Receiving Maintenance Dialysis 12. Bell CM, Redelmeier DA. Mortality among patients admitted to hospitals on 45. Hansen KW, Hvelplund A, Abildstrøm SZ, Prescott E, Madsen M, Madsen JK, Admitted Over Weekends. Ankit Sakhuja. AJKD 2013; 62(4): 763-770 weekends as compared with weekdays. N Engl J Med. 2001 Aug 30; 345(9): Jensen JS, Sørensen R, Galatius S. Prognosis and treatment in patients http://www.ncbi.nlm.nih.gov/pubmed/23669002 663-8 http://www.ncbi.nlm.nih.gov/pubmed/11547721 admitted with acute myocardial infarction on weekends and weekdays from 1997 to 2009.
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