• William C Johnson, Nicolas A Morton-Gonzaba, John V Lacci, Daniel Godoy, Alireza Mirahmadizadeh, and Ali Seifi.
• School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
• Neurocrit Care. 2019 Apr 1; 30 (2): 293300293-300.

ObjectiveMultiple studies have shown worse outcomes in patients admitted for medical and surgical conditions on the weekend. However, past literature analyzing this "weekend effect" on subarachnoid hemorrhage (SAH) found no significant increase in mortality. This study utilizes more recent data to re-evaluate the association between weekend admission and mortality of patients hospitalized for SAH.MethodsThis retrospective cohort study queried the SAH patients in the Nationwide Inpatient Sample (NIS) database who were discharged from 2006 through 2014 during the weekend.ResultsOf the 54,703 admissions for SAH identified during the study period, 14,821 (27.1%) occurred over the weekend. Patients admitted over the weekend had a mean age of 59.2 years and were most likely to be female (59.6%), to be white (62.9%), located in the south region of the USA (40.1%), and be admitted to a teaching hospital (74.4%). When compared directly to weekday admissions, patients admitted over the weekend had higher odds of in-hospital mortality (odds ratio 1.07; confidence interval 95%, 1.02-1.12). There was no significant difference shown in the rate patients get surgical clipping versus endovascular coiling (p = 0.28) or the amount of time between admission to procedure for clipping (p = 0.473) or coiling (p = 0.255) on the weekend versus a weekday.ConclusionBased on our findings, the likelihood of the in-hospital mortality was higher for patients admitted over the weekend. However, the characteristics of the study, primarily observational, prevent us arriving at an accurate conclusion about why this occurs; hence, we believe it is an important starting point to consider for future research.

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