“Weekend Effect” and Pediatric IBD

The “weekend effect” is a term used to indicate that outcomes for many medical conditions are worse when patients are admitted to the hospital on the weekend.

A recent study (MD Egberg et al. Inflamm Bowel Dis 2020; 26: 254-60; editorial by C Ballengee Menchini 261-2) documents the degree of this effect on the risk of complications for pediatric patients with inflammatory bowel disease (IBD).

This study used a cross-sectional analysis with the Kids’ Inpatient Database (KID), a nationally representative database.  The study included 3255 urgent surgical hospitalizations and included patients 18 years old and younger.

Key findings:

  • The risk difference for weekend Crohn’s disease (CD) surgical hospitalizations involving a complication vs weekday hospitalizations was 4%
  • The risk difference for weekend ulcerative colitis (UC) surgical hospitalizations involving a complication vs weekday hospitalizations was 7%
  • The relative risk of surgical complications was 30% and 70% higher for weekend admissions for CD and UC respectively
  • For both weekend and weekday admissions, the most common complications were ‘postoperative intestinal/hepatic complications,’ ileus and sepsis
  • Hospital teaching status and population-density did not affect outcomes

Possible Reasons for Weekend Effect:

  • Reduced hospital staffing
  • Delayed seeking care by patients which increases illness severity
  • Reduced access to diagnostic resources
  • Lack (or reduced) of access to specialist care

Limitations include reliance on administrative data and potential for misclassification and unidentified confounding variables.

Related blog post:

From Weekend Hike on Mount Yonah:

 

 

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