Educational Objective: At the conclusion of this presentation, the participants should be able to determine the effect of weekend admission for patients who received surgical repair of facial fracture.
Objectives: A "weekend effect" has been described as worse outcomes for patients admitted on weekends. In this analysis we seek to determine the effect of weekend admission for patients who received surgical repair of facial fracture.
Study Design: Retrospective database analysis.
Methods: The National Inpatient Sample (NIS) was used to identify 18,025 patients undergoing facial fracture repair the day of hospital admission from 2003-2014. Variables included patient and hospital demographics. Admissions were assessed by weekend or weekday admission status. Univariate and multivariate analyses were performed.
Results: 18,025 patients were identified, with 12,785 (71.43%) weekday admissions and 5240 (29.07%) weekend admissions. A total of 56.7% of weekend admissions were emergency or urgent admissions in comparison to 45.5% for weekdays. Cox regression analysis demonstrated better overall survival for weekend patients (HR: 0.48 95% CI: 0.238-0.969, p<0.05). Patients with higher APR-DRG risk of mortality were found to have higher risk of death (HR: 22.572 95% CI: 3.565-142.91, p<0.001). Weekday admissions were associated with decreased total charges (mean difference: -$5581, 95% CI: -8179 to -2984, p<0.0001) and length of stay (-0.277 days, 95% CI: -0.49 to -0.064, p<0.05) as compared to weekend admission. Multivariate logistic analysis demonstrated no significant difference in mortality during hospitalization or adverse discharge disposition.
Conclusions: Weekend admission status may play a role in outcomes following facial fracture repair. Patients admitted on weekdays had significantly decreased length of stay as well as total charges, but no differences in mortality or discharge disposition.