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Impact of weekend admission on mortality and other outcomes among patients with burn injury: A nationwide analysis.
- Source :
-
Burns (03054179) . Dec2017, Vol. 43 Issue 8, p1654-1661. 8p. - Publication Year :
- 2017
-
Abstract
- <bold>Objective: </bold>To study the relationship between day of admission and important outcomes among patients with burn injuries.<bold>Methods: </bold>The 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.<bold>Results: </bold>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 >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).<bold>Conclusions: </bold>Weekend 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BURNS & scalds
*HOSPITAL admission & discharge
*LENGTH of stay in hospitals
*ARTIFICIAL respiration
*SEPTIC shock
*CONFIDENCE intervals
*DIAGNOSIS
*HOSPITAL care
*HOSPITAL costs
*MEDICAL care
*PATIENTS
*TIME
*TRACHEA intubation
*LOGISTIC regression analysis
*RETROSPECTIVE studies
*HOSPITAL mortality
*ODDS ratio
*ECONOMICS
Subjects
Details
- Language :
- English
- ISSN :
- 03054179
- Volume :
- 43
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Burns (03054179)
- Publication Type :
- Academic Journal
- Accession number :
- 126574874
- Full Text :
- https://doi.org/10.1016/j.burns.2017.08.005