An evaluation of the 'weekend effect' in patients admitted with metastatic prostate cancer
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An evaluation of the 'weekend effect' in patients admitted with metastatic prostate cancer. / Schmid, Marianne; Ghani, Khurshid R; Choueiri, Toni K; Sood, Akshay; Kapoor, Victor; Abdollah, Firas; Chun, Felix K; Leow, Jeffrey J; Olugbade, Kola; Sammon, Jesse D; Menon, Mani; Kibel, Adam S; Fisch, Margit; Nguyen, Paul L; Trinh, Quoc-Dien.
in: BJU INT, Jahrgang 116, Nr. 6, 12.2015, S. 911-9.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - An evaluation of the 'weekend effect' in patients admitted with metastatic prostate cancer
AU - Schmid, Marianne
AU - Ghani, Khurshid R
AU - Choueiri, Toni K
AU - Sood, Akshay
AU - Kapoor, Victor
AU - Abdollah, Firas
AU - Chun, Felix K
AU - Leow, Jeffrey J
AU - Olugbade, Kola
AU - Sammon, Jesse D
AU - Menon, Mani
AU - Kibel, Adam S
AU - Fisch, Margit
AU - Nguyen, Paul L
AU - Trinh, Quoc-Dien
N1 - © 2014 The Authors BJU International © 2014 BJU International.
PY - 2015/12
Y1 - 2015/12
N2 - OBJECTIVES: To investigate whether mortality is increased for patients with metastatic prostate cancer (mCaP) admitted over the weekend.PATIENTS AND METHODS: Using the Nationwide Inpatient Sample (NIS) between 1998 and 2009, admitted patients with a diagnosis of prostate cancer and concomitant metastases were identified. Rates of in-hospital mortality, complications, use of imaging and procedures were assessed. Adjusted logistic regression models examined associations of mortality and complications.RESULTS: A weighted sample of 534,011 patients with mCaP was identified, including 81.7% weekday and 18.3% weekend admissions. Of these, 8.6% died after a weekday vs 10.9% after a weekend admission (P < 0.001). Patients admitted over the weekend were more likely to be treated at rural (17.8% vs 15.7%), non-teaching (57.6% vs 53.7%) and low-volume hospitals (53.4% vs 49.4%) (all P < 0.001) compared with weekday admissions. They presented higher rates of organ failure (25.2% vs 21.3%), and were less likely to undergo an interventional procedure (10.6% vs 11.4%) (all P < 0.001). More patients admitted over the weekend had pneumonia (12.2% vs 8.8%), pyelonephritis (18.3% vs 14.1%) and sepsis (4.5% vs. 3.5%) (all P < 0.001). In multivariate analysis, weekend admission was associated with an increased likelihood of complications (odds ratio [OR] 1.15, 95% confidence Interval [CI] 1.11-1.19) and mortality (OR 1.20, 95% CI 1.14-1.27).CONCLUSION: In patients with mCaP weekend admissions are associated with a significant increase in mortality and morbidity. Our findings suggest that weekend patients may present with more acute medical issues; alternatively, the quality of care over the weekend may be inferior.
AB - OBJECTIVES: To investigate whether mortality is increased for patients with metastatic prostate cancer (mCaP) admitted over the weekend.PATIENTS AND METHODS: Using the Nationwide Inpatient Sample (NIS) between 1998 and 2009, admitted patients with a diagnosis of prostate cancer and concomitant metastases were identified. Rates of in-hospital mortality, complications, use of imaging and procedures were assessed. Adjusted logistic regression models examined associations of mortality and complications.RESULTS: A weighted sample of 534,011 patients with mCaP was identified, including 81.7% weekday and 18.3% weekend admissions. Of these, 8.6% died after a weekday vs 10.9% after a weekend admission (P < 0.001). Patients admitted over the weekend were more likely to be treated at rural (17.8% vs 15.7%), non-teaching (57.6% vs 53.7%) and low-volume hospitals (53.4% vs 49.4%) (all P < 0.001) compared with weekday admissions. They presented higher rates of organ failure (25.2% vs 21.3%), and were less likely to undergo an interventional procedure (10.6% vs 11.4%) (all P < 0.001). More patients admitted over the weekend had pneumonia (12.2% vs 8.8%), pyelonephritis (18.3% vs 14.1%) and sepsis (4.5% vs. 3.5%) (all P < 0.001). In multivariate analysis, weekend admission was associated with an increased likelihood of complications (odds ratio [OR] 1.15, 95% confidence Interval [CI] 1.11-1.19) and mortality (OR 1.20, 95% CI 1.14-1.27).CONCLUSION: In patients with mCaP weekend admissions are associated with a significant increase in mortality and morbidity. Our findings suggest that weekend patients may present with more acute medical issues; alternatively, the quality of care over the weekend may be inferior.
KW - Aged
KW - Aged, 80 and over
KW - Hospitalization
KW - Hospitals
KW - Humans
KW - Male
KW - Middle Aged
KW - Prostatic Neoplasms
KW - Quality of Health Care
KW - Time Factors
U2 - 10.1111/bju.12891
DO - 10.1111/bju.12891
M3 - SCORING: Journal article
C2 - 25099032
VL - 116
SP - 911
EP - 919
JO - BJU INT
JF - BJU INT
SN - 1464-4096
IS - 6
ER -
