Turns out, patients are more likely to die during off-hours or on weekends - whether due to a brain bleed, a heart attack or a blood clot in the lungs. Doctors call it the “weekend effect”.
A new study, based on a previous research about lower survival rates from in-hospital cardiac arrest during nights and weekends, showed that the “survival trends during the odd-hours have improved in the past decade or so”.
The new study, carried by Dr. Uchenna Ofoma, indicated that the treatment has gotten better but the night-and-weekends gap is yet to be closed. Dr. Ofoma is an assistant professor of medicine at Temple University and a critical care physician at Geisinger Health System in Danville, Pennsylvania.
The study stated that between 2000 and 2014, weekend survival jumped from 16 % to 25.5 %, while weekend-weeknight survival rose to 21.9 % from 11.9 %.
It is also noted that there was no significant change in the gap between weekday and off-hours survival rate.
Around 300,000 patients from 470 hospitals were monitored for the research. It showed that more than half of the patients being studied experienced cardiac arrest during off-hours.
Dr. Seth Goldstein, a pediatric surgical fellow at John Hopkins Hospital shared his views. He said that children admitted to the hospital for common, urgent surgeries on weekends had a higher adjusted risk of death, blood transfusion and other complications.
Though not directly involved with the new research, Goldstein made the observation based on his own research on a similar topic. He pointed that perhaps hospitals are understaffed and doctors are fatigued during off-hours, which result in such situations.
He also surmised that maybe the patients who made it to hospital during off-hours or weekends were worse off to begin with. For example, those might be times when people are more likely to drink and injure themselves, resulting in severe surgeries.
Similarly, Ofoma and his team noted that the patients whose hearts stopped off-hours could have been sicker in ways that weren’t measured by the study. Their cardiac arrests were also less likely to be witnessed by someone else in the hospital.
They also noted the difference between patients who experienced heart attacks or cardiac arrests outside and inside the hospital. For people experiencing heart attack outside the hospital, time was of essence. For someone to perform CPR or defibrillation was the key to survival.
Ofoma believes that there’s a way to tackle the survival gap on nights and weekends. She insisted to look at which hospitals have the smallest difference, and figure out what they’re doing right. Goldstein believes that hospitals can close the gap by changing how they run. More staffing and better ways of alerting doctors and nurses if their patients take a turn for the worst should bring out a huge difference. The study is published in Journal of the American College of Cardiology.