Hospital “Weekend Effect” Study Highlights Patient Risks During Off Hours

Individuals who suffer a cardiac arrest while in the hospital over the weekend may face much greater health risks than those who experience the same issues during a weekday, according to the findings of a new study.  

Researchers with Temple University found that there is a higher risk of death following a hospital cardiac arrest that occurs on weekends. The findings were published this month in the Journal of the American College of Cardiology.

The study involved data for more than 150,000 adults at over 470 hospitals across the United States. Patients were a part of the Get with the Guidelines–Resuscitation registry during 2000 to 2014.

Lower survival rates on the weekend or weeknights is known in the healthcare industry as the “weekend effect.” It has been documented among other studies and shown to be a factor in death rates in some instances. This latest study focused on whether the so-called “weekend effect” has improved over the past decade.

A study published last year indicated patients who have an angioplasty on the weekend have a higher risk of death than those who undergo an angioplasty during a weekday. This same “weekend effect” has been previously demonstrated among in-hospital cardiac arrest patients. Temple University researchers wanted to see if this was still the case.

Overall, about 52% of patients suffered cardiac arrest during off-hours, either on the weekend or weeknights. The study data did show a difference between survival rates for the weekend compared to weekdays.

Patients who had cardiac arrest on a weekday initially had a survival rate of 16% in 2000. However that increased to 25% by 2014. Survival rates for patients who had cardiac arrest on a  weeknight or weekend was only about 12%, that increased to nearly 22% by 2014.

While survival rates overall improved over the ten year study period, the “weekend effect” was still a factor. Patients who had cardiac arrest had a lower survival rate if they experienced the episode on a weekend or weeknight.

More so, researchers noted the survival to discharge rate for weekend patients was 17%. The survival to discharge rate for weekday patients was 21%.

The “weekend effect” is still prevalent among cardiac arrest patients, despite processes implemented to prevent the phenomenon, the researchers concluded. They indicated the weekend effect still affected patients, whether it was a heart attack, blood clot, or brain bleed.

Many factors may be a part of the cause, according to the report, including doctors who are fatigued and have worked long shifts, as well as understaffed hospitals.

Researchers also note that some patients who come in on nights and weekends may simply be worse off than those that come in during the day because that is when people are more likely to have accidents, drink and experience problems or other similar issues. It can also be more difficult for hospital staff to obtain lab results, x-rays, and EKGs during off-hours.

However, the study suggests that implementing certain changes may help to improve the “weekend effect.” By changing how hospitals operate, survival rates may improve. This includes increasing staffing, finding improved ways to alert doctors and nurses when a patient’s condition worsens, and improving communication between the team as a whole.