A new Johns Hopkins study has found that patients injured and hospitalized on the weekend are more likely to to die than patients admitted on a weekday.
The study provides further evidence of the so-called "weekend effect," a phenomenon that has been examined in several studies involving heart attack, stroke and aneurism patients.
The study examined the medical records of 38,675 patients between the ages of 65 and 89 who were admitted to U.S. hospitals for head trauma injuries. Ultimately, weekend head injuries were more likely to be fatal even if they were "less severe or the patient had fewer comorbidities than someone similarly hospitalized on a weekday."
Each year, about 1.4 million Americans are hospitalized for head trauma, according to the study's researchers. Of these, more than 50,000 die annually as a result of their injuries. The researchers found that weekend patients were 14 percent more likely to die from their injuries than weekday patients, even after accounting for other factors such as age or compounding illnesses.
“There isn’t a medical reason for worse results on weekends,” said study leader Eric B. Schneider, Ph.D., an epidemiologist at the Johns Hopkins University School of Medicine’s Center for Surgical Trials and Outcomes Research in a press release. “It’s more likely a difference in how hospitals operate over the weekend as opposed to during the week, meaning that there may be a real opportunity for hospitals to change how they operate and save lives.”
In the release, Schneider notes that hospitals often have fewer veteran doctors and nurses working on weekends, and it may be harder to summon specialists quickly. But hospitals may not be able to afford maintaining the same staffing levels on Saturdays and Sundays then they do during the week. A more practical solution may be to transport elderly, at-risk head trauma patients to the nearest trauma center, even if that means passing over closer facilities that may not be prepared to offer the appropriate level of care.
The study is only the latest in a series of research documenting the weekend effect, however.
According to the Star Ledger, throughout the past 10 years studies have linked weekend admissions to lower standards of care and higher mortality rates for heart attack victims and patients with end-stage renal failure. A study published in the United Kingdom in June found that more stroke patients die when hospitalized on the weekend, ABC reports. This is an important consideration, given that according to the CDC, someone dies from a stroke in the U.S. every four minutes.
In May 2011, a team of researchers from Tufts Medical School found higher mortality rates in nonelective hospital admissions on the weekend across the U.S. throughout a five-year period. Even a 1 percent higher mortality rate can affect thousands of patients, said Rocco Ricciardi, a surgeon and the lead author of the study, which was published in the May 2011 edition of the Archives of Surgery. Ricciardi's team found that between 2003 and 2007, as many as 25,000 extra deaths could be attributed to the weekend effect.
Of course, not everyone thinks the phenomenon is quite as big of a deal as some researchers suggest.
In a 2011 Star Ledger article, Gary Horan, president and CEO of Trinitas Medical Center in Elizabeth, N.J., downplayed the effect. "People forget — we are a 24-hour operation," Horan said. "[The weekend effect] is a tempest in a teapot."