• Burns · Dec 2017

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

    • Heather Peluso, Marwan S Abougergi, and Julie Caffrey.
    • Department of Surgery, University of South Carolina, Greenville Health System, 701 Grove Road, Greenville, SC 29605, United States. Electronic address: hpeluso@ghs.org.
    • Burns. 2017 Dec 1; 43 (8): 1654-1661.

    ObjectiveTo study the relationship between day of admission and important outcomes among patients with burn injuries.MethodsThe 2014 National Inpatient Sample database was used. Inclusion criterion was a principal diagnosis of burn injury. Exclusion criteria were age <18years, 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.ResultsA 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 >65years 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).ConclusionsWeekend admission is associated with increased mortality among patients with burn injury >65years old. Weekend admission is also associated with increased morbidity and prolonged length of stay.Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

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