Weekend Admission for Acute Leukemia Negatively Affects Mortality Rate

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Researchers assessed various factors, including weekend/weekday admissions, mortality rates, demographic differences, preexisting comorbidities, and nosocomial complications.
Researchers assessed various factors, including weekend/weekday admissions, mortality rates, demographic differences, preexisting comorbidities, and nosocomial complications.

Mortality rates were found to be higher in weekend hospitals admissions compared with weekdays among patients with acute leukemia, according to a poster presentation at the 2018 American Society of Clinical Oncology (ASCO) Annual Meeting.

Previous studies have been performed to determine the association between mortality outcomes and weekend admissions for patients with various acute illnesses, but the impact of acute leukemia has not been studied.

Using the 2002-2012 Nationwide Inpatient Sample Database, researchers assessed the outcomes of 71,392 patients with acute leukemia who underwent hospital admissions. Investigators assessed various factors, including weekend or weekday admissions, rates of mortality, demographic differences, preexisting comorbidities at admission, and nosocomial complications. 

Overall, 17.1% (12.234) of patients were found to have been admitted over the weekend. While researchers noted a steady decline in mortality and hospital admission rates for patients with leukemia over the study period, mortality was significantly improved among patients who were admitted on weekdays compared with weekends (16.3% vs 18.8%; P<.001). 

Analysis revealed that weekend hospital admission was an independent predictor of mortality in this patient population (adjusted odds ratio [aOR], 1.128; 95% CI, 1.06-1.20; P<.001). 

Weekend admissions were also significantly associated with an increased likelihood to undergo early bone marrow biopsies with 45% vs 26.5% among weekday admissions (P<.001), and were at an increased risk of developing in-hospital hospitalizations (52.4% vs 50.5%; P<.001). Bone marrow biopsy however, was independently associated with decreased in-hospital mortality (aOR, 0.395; 95% CI, 0.373-0.417; P<.001). 

Being admitted to teaching hospitals was associated with improved mortality (aOR, 0.890; 95% CI, 0.845-0.936; P<.001). 

The authors concluded that “our study suggests that patients admitted over the weekend may be clinically sicker or receive inferior care than weekday admissions. We also conclude that patients admitted to teaching hospitals have a better outcome and emphasize the importance of availability of resources and early presentation to tertiary care centers.”

Reference

Parikh K, Shah M, Mehta D, et al. Differences in mortality among patients with acute leukemia admitted on weekends as compared to weekdays. Poster presentation at: 2018 ASCO Annual Meeting; June 1-5, 2018; Chicago, IL. 

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