Related Experiment Video
Updated: Aug 2, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
A Nationwide Analysis of Outcomes of Weekend Admissions for Intracerebral Hemorrhage Shows Disparities Based on
Achint A Patel1, Abhimanyu Mahajan2, Alexandre Benjo3
1Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Insights
Weekend admissions for intracranial hemorrhage (ICH) are linked to higher in-hospital mortality and adverse discharge. This weekend effect in stroke care highlights disparities and the need for improved adherence to standard-of-care guidelines.
Area of Science:
- Neurology
- Public Health
- Healthcare Management
Background:
- The
- weekend effect
- in healthcare, where patient outcomes differ based on admission day, is well-documented, particularly for stroke care.
Purpose of the Study:
- To investigate the presence and trends of a
- weekend effect
- on hospital outcomes for patients with intracranial hemorrhage (ICH).
Main Methods:
- Utilized the Nationwide Inpatient Sample (NIS) database, analyzing 485,329 ICH admissions from 2002 to 2011.
- Employed multivariable logistic regression to compare weekend versus weekday admissions regarding mortality, adverse discharge, length of stay, and cost.
Main Results:
- Weekend ICH admissions were associated with an 11% higher odds of in-hospital mortality and a 9% higher likelihood of adverse discharge.
- While the excess mortality showed a temporal decline, it persisted in non-teaching hospitals.
- No significant effect of weekend admission was observed on length of stay or cost of care.
Conclusions:
- Nontraumatic ICH admissions on weekends are associated with poorer in-hospital outcomes, including increased mortality and adverse discharge.
- These findings underscore the need for further investigation into the causes of this discrepancy and stricter adherence to established stroke care guidelines to ensure equitable patient care.
Background And Purpose:
With the "weekend effect" being well described, the Brain Attack Coalition released a set of "best practice" guidelines in 2005, with the goal to uniformly provide standard of care to patients with stroke. We attempted to define a "weekend effect" in outcomes among patients with intracranial hemorrhage (ICH) over the last decade, utilizing the Nationwide Inpatient Sample (NIS) data. We also attempted to analyze the trend of such an effect.
Materials And Methods:
We determined the association of ICH weekend admissions with hospital outcomes including mortality, adverse discharge, length of stay, and cost compared to weekday admissions using multivariable logistic regression. We extracted our study cohort from the NIS, the largest all-payer data set in the United States.
Results:
Of 485 329 ICH admissions from 2002 to 2011, 27.5% were weekend admissions. Overall, weekend admissions were associated with 11% higher odds of in-hospital mortality. When analyzed in 3-year groups, excess mortality of weekend admissions showed temporal decline. There was higher mortality with weekend admissions in nonteaching hospitals persisted (odds ratios 1.16, 1.13, and 1.09, respectively, for 3-year subgroups). Patients admitted during weekends were also 9% more likely to have an adverse discharge (odds ratio 1.09; 95% confidence interval: 1.07-1.11; P < .001) with no variation by hospital status. There was no effect of a weekend admission on either length of stay or cost of care.
Conclusion:
Nontraumatic ICH admissions on weekends have higher in-hospital mortality and adverse discharge. This demonstrates need for in-depth review for elucidating this discrepancy and stricter adherence to standard-of-care guidelines to ensure uniform care.
Related Concept Videos
01:17Hemorrhagic Stroke l: Introduction
01:29Hemorrhagic Stroke ll: Pathophysiology