A Johns Hopkins review of more than 38,000 patient records finds that older adults who sustain substantial head trauma over a weekend are significantly more likely to die from their injuries than those similarly hurt and hospitalized Monday through Friday, even if their injuries are less severe and they have fewer other illnesses than their weekday counterparts.
The so-called "weekend effect" on patient outcomes has been well documented in cases of heart attack, stroke and aneurism treatment, Hopkins investigators say, and the new research now affirms the problem in head trauma care as well."
A report on the findings, published online in the Journal of Surgical Research, suggests that reduced staffing levels and/or lack of ready access to specialists are factors in the higher weekend death rates after head injury.
"There isn't a medical reason for worse results on weekends," says 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. "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."
Approximately 1.4 million Americans suffer head trauma that results in a hospital visit each year, the researchers say, and more than 50,000 die annually as a result of their injuries. An estimated 235,000 require inpatient care.
Schneider notes that unlike other forms of trauma that disproportionately affect young people, head trauma and mortality associated with it increase as people age, with the highest rates of hospitalization and death for such injuries occurring in people over 75.
Using data from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample from 2006 to 2008, Schneider and his colleagues examined records from 38,675 people between 65 and 89 years of age admitted to U.S. hospitals with head trauma. In the study group, 9,937 admissions (or 25.6 percent) occurred on weekends.