The impact of holiday season and weekend effect on traumatic injury mortality: Evidence from a 10-year analysis

Abstract

A BSTRACT Objectives: Trauma is one of the leading causes of death and its incidence increases annually. The “weekend effect” and “holiday season effect” on traumatic injury mortality remain controversial, whereby traumatic injury patients admitted during weekends and/or holiday season have a higher risk of in-hospital death. The present study is aimed to explore the association between “weekend effect” and “holiday season effect” and mortality in traumatic injury population. Materials and Methods: This retrospective descriptive study included patients from the Taipei Tzu Chi Hospital Trauma Database between January 2009 and June 2019. The exclusion criterion was age of < 20 years. The primary outcome was the in-hospital mortality rate. The secondary outcomes included intensive care unit (ICU) admission, ICU re-admission, length of stay (LOS) in the ICU, ICU admission duration ≥ 14 days, total hospital LOS, total hospital LOS ≥ 14 days, need for surgery, and re-operation rate. Results: In this study, 11,946 patients were included in the analysis, and 8143 (68.2%) patients were admitted on weekdays, 3050 (25.5%) on weekends, and 753 (6.3%) on holidays. Multivariable logistic regression revealed that the admission day was not associated with an increased risk of in-hospital mortality. In other clinical outcome analyses, we found no significant increase in the risk of in-hospital mortality, ICU admission, ICU LOS ≥ 14 days, or total LOS ≥ 14 days in the weekend and holiday season groups. The subgroup analysis showed that the association between holiday season admission and in-hospital mortality was noted only in the elderly and shock condition populations. The holiday season duration did not differ in terms of in-hospital mortality. Longer holiday season duration was also not associated with an increased risk of in-hospital mortality, ICU LOS ≥14 days, and total LOS ≥14 days. Conclusion: In this study, we did not find any evidence that weekend and holiday season admissions in the traumatic injury population were associated with an increased risk of mortality. In other clinical outcome analyses, there was no significant increase in the risk of in-hospital mortality, ICU admission, ICU LOS ≥ 14 days, or total LOS ≥ 14 days in the weekend and holiday season groups.

Use of Reverse Shock Index Multiplied by Simplified Motor Score in a Five-Level Triage System: Identifying Trauma in Adult Patients at a High Risk of Mortality

“…Traumatic injury is a major global health problem, contributing to both mortality and disability and placing a substantial burden on healthcare systems [1]. Several triage tools have been developed for use in both prehospital and hospital settings, including the Canadian Triage and Acuity Scale (CTAS) [2], the Emergency Severity Index (ESI) [3], the Manchester Triage Scale [4], the Taiwan Triage and Acuity Scale (TTAS) [5,6], and the Australasian Triage Scale [7].…”

Association between Time to Emergent Surgery and Outcomes in Trauma Patients: A 10-Year Multicenter Study

“…In Taiwan, level 1 trauma centers, which are accredited on the basis of their emergency capacity, have attending surgeons available 24/7 for all major trauma resuscitations. These centers also provide resuscitation interventions such as transcatheter arterial embolization or surgery, even on weekends and holidays [ 6 , 8 ]. Although studies have reported the optimal time to definitive care to be 2 h for procedures such as exploratory laparotomy and craniotomy at level 1 hospitals, in Taiwan, the time limit for emergent trauma surgeries is typically 30 min [ 9 , 10 ].…”