Increased Mortality Among Patients with Acute Leukemia Admitted on Weekends as Compared to Weekdays.
The association between weekend admission and patient outcomes has been reported in several acute illnesses, but is unknown in acute leukemia.
We used the 2002-2014 Nationwide Inpatient Sample to identify patients admitted with a primary diagnosis of acute leukemia. Admissions were classified as weekend or weekday admissions for comparison. Hierarchical logistic regression models were used to analyze predictors of hospital-mortality.
There was a 22.3% decline in acute leukemia admissions in 2014 compared to 2002 and a 4% decline in in-hospital mortality (19.0% to 14.9%; p<0.001). 82,833 admissions were included in the study, and 14,241 (17.19%) occurred over the weekend. Hospital mortality was higher for weekend than weekday admissions (18.8% vs. 16.1%; p<0.001). Weekend admissions were less likely to receive early bone marrow biopsy than their weekday counterparts (27.5% vs. 46.3%; p<0.01). Bone marrow biopsy (adjusted odds ratio 0.36, 95% CI 0.33-0.39; p<0.001) and admissions to a teaching hospital (adjusted odds ratio (aOR) 0.65, 95% CI 0.56-0.75; p<0.001) independently predicted lower hospital-mortality. Weekend admission was associated with higher hospital-mortality (aOR 1.12, 95 CI, 1.02-1.23; p=0.01) and more complications than weekday admissions (50.6% vs. 47.8%; p<0.001).
There was significantly increased mortality among weekend admissions for acute leukemia. Mortality was reduced among patients admitted to teaching hospitals.
Published In/Presented At
Parikh, K. Shah, M. Mehta, D. Arora, S. Patel, N. Liu, D. (2017). Increased Mortality Among Patients with Acute Leukemia Admitted on Weekends as Compared to Weekdays. Clinical Lymphoma Myeloma and Leukemia. doi.org/10.1016/j.clml.2017.07.256
Cardiology | Medical Sciences | Medicine and Health Sciences
Department of Medicine, Cardiology Division
This document is currently not available here.