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:

• Weekend Effect –From the Other Side of the Bed
• Good care 24/7 | gutsandgrowth
• The Indispensable Physician | gutsandgrowth

From Weekend Hike on Mount Yonah: