Increased Weekend Mortality

The subject of increased weekend mortality for patients admitted over the weekend has been mentioned in this blog previously. This has been attributed to reduced availability of consultants over the weekend. However, a causal link between reduced consultant cover and worse outcomes is unproven. If consultant availability is the main factor behind the weekend effect, then we would expect to see a surge in mortality if consultant presence dropped over the working week. Jena et al. (2015) [1] studied mortality rates of patients admitted for myocardial infarction, cardiac arrest, or heart failure during normal times compared to periods when national cardiology meetings were taking place in the USA. A sizeable proportion of heart specialists down tools to attend the conference. Surprisingly, not only were adjusted 30-day mortality rates not increased, but they were lower among high-risk patients admitted during meetings compared to those admitted at other times. The American College of Cardiology responded by saying they were reassured that during dates of national meetings, patients received care that was no worse than normal. But is the lower risk really reassuring if you are a heart specialist! The CLAHRC WM Director reflects that the premise behind the paper may be wrong and sufficient specialists, or near specialists, stay behind to manage the acute service over the conference period.

— Samuel Watson, Research Fellow

Reference:

1. Jena AB, Prasad V, Goldman DP, Romley J. Mortality and Treatment Patterns Among Patients Hospitalized With Acute Cardiovascular Conditions During Dates of National Cardiology Meetings. JAMA Intern Med. 2015; 175(2): 237-44.