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'Weekend Effect' Boosts Trauma Patients' Survival Chances

John Commins, for HealthLeaders Media, March 23, 2011

Trauma patients who've been hurt in car or bike crashes, shot, stabbed, or suffered other injuries are more likely to live if they arrive at the hospital on the weekend than during the week, according to a study from the University of Pennsylvania School of Medicine.

The research, published in the current issue of Archives of Surgery, also shows that trauma patients who present to the hospital on weeknights are no more likely to die than those who present during the day, contrasting previous studies showing a so-called "weekend effect" in which patients with emergent illnesses such as heart attacks and strokes fare worse when they're hospitalized at night or on weekends.

The study found that the trauma system's unique organization and staffing appears to serve as a built-in protection for these critically injured patients, and may provide a roadmap for restructuring and coordinating emergency care.

"Whether patients have an emergent illness or a severe injury, the common denominator is time. Patients must rely on the system to quickly get them to the place that's best prepared to save their lives," said Brendan G. Carr, MD, an assistant professor in the departments of Emergency Medicine and Biostatistics and Epidemiology, and a lead author of the study. "Trauma systems have been designed to maximize rapid access to trauma care, and our results show that the system also offers special protection for patients injured during periods that are known to be connected to worse outcomes among patients with time-sensitive illnesses."

The researchers studied 90,461 patients who were treated from 2004 to 2008 at Pennsylvania's 32 accredited trauma centers. About 25% of the patients presented to the hospital on weeknights -- defined as 6 p.m. to 9 a.m. Monday through Friday -- and about 40% arrived on weekends -- 6 p.m. Friday to 9 a.m. on Monday. Neither the weekend or night patient groups experienced delays for crucial brain or abdominal surgeries often required for trauma patients, compared to weekday patients, the study found.

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