Impact of the ‘weekend effect’ on hospital-acquired pneumonia after aneurysmal subarachnoid hemorrhage

ABSTRACT

Objectives

Weekend admission has been reported to be associated with poor clinical outcomes of various diseases. This study aimed to determine whether weekend admission increases the incidence of hospital-acquired pneumonia (HAP) in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods

We retrospectively analyzed aSAH patients admitted to our hospital between 2014 and 2020. These patients were divided into weekend and weekday groups. We compared the incidence of HAP and other clinical outcomes between the two groups. Risk factors for HAP were identified by logistic regression analysis.

Results

Of 653 included aSAH patients, 145 (22%) were admitted on weekends and 508 (78%) were admitted on weekdays. The incidence of HAP in the weekend group was significantly higher than that in the weekday group (25% vs 16%, P = 0.01). The weekend group showed worse clinical outcomes, including worse neurological outcome (74% vs 65%, P = 0.03), higher risk of intensive care unit (ICU) admission (21% vs 13%, P = 0.01) and longer length of stay (21.3 vs 16.4 days, P < 0.01). Age ≥ 60 years (odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.3–3.0, P < 0.01), modified Fisher score (MFS) ≥ 3 (OR = 1.7, 95% CI = 1.1–2.6, P = 0.02), weekend admission (OR = 1.8, 95% CI = 1.1–2.8, P = 0.02) and operative treatment (OR = 2.3, 95% CI = 1.2–4.5, P = 0.02) were risk factors for HAP following aSAH.

Conclusion

Weekend admission was associated with a higher incidence of HAP in aSAH patients. This study suggested that medical administrators may need to optimize healthcare services on weekends.

KEYWORDS:

• Weekend admission
• weekend effect
• subarachnoid hemorrhage
• clinical outcomes
• hospital-acquired pneumonia

Declaration of financial/other relationships

The authors declare there are no conflicts of interest. Peer reviewers on this manuscript have no financial or other relationships to disclose.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China [grant: No.81860222, No.81960220, No.81901394]; Innovation Project of Guangxi Graduate Education [YCBZ2021049].