Weekend admittance may increase mortality risk for COPD patients
MedWire News: Patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) are more likely to die if admitted to hospital at the weekend than on a weekday, Spanish research shows.
Writing in the European Respiratory Journal, Raquel Barba (Hospital Infanta Cristina, Madrid, Spain) and team explain that "the recognition of risk factors for mortality among patients hospitalized for COPD can be of crucial importance for curtailing cost and reducing mortality."
They add: "Differences in hospital staffing may influence outcomes for patients with acute conditions, including acute exacerbations of COPD, depending on which day of the week the patients are admitted."
To investigate, the team studied data on 289,077 adults (69.9% men), aged a mean of 73.9 years, who were admitted to hospital for acute COPD exacerbations between 2006 and 2007. Of these, 69,770 (24.1%) were admitted at weekends, and 219,307 (75.9%) on weekdays.
In total, 35,544 (12.4%) patients died during their hospital stay.
Analysis revealed that patients admitted to hospital at the weekend had significantly higher inhospital mortality rates than those admitted on weekdays, at 12.9% versus 12.1% (odds ratio [OR]=1.07).
The increased risk for death among patients admitted to hospital at the weekend remained significantly elevated, at an OR of 1.05, after accounting age, gender, and comorbid conditions, the researchers note.
Analysis of mortality rates within 1 and 2 days of admission revealed an even greater risk for death among patients admitted at weekends compared with those admitted on weekdays, at respective adjusted ORs of 1.39 and 1.17.
Barba and team conclude: "This study has demonstrated that, among a large, representative population of patients admitted to the hospital for COPD exacerbation… mortality was higher among COPD patients admitted on weekends than among those admitted on weekdays."
They add: "Efforts should be made to increase the efficacy and decrease the fallibility of doctors during periods of short staffing."
MedWire (http://www.medwire-news.md/) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
By Mark Cowen