“The weekend effect.” Doctors have coined the term to describe the greater likelihood hospital patients die during off-hours. And new research confirms the phenomenon is real.
According to a study in the Journal of the American College of Cardiology, the nights-and-weekends death gap is significant, despite some improvements in recent years.
The study tracked more than 150,000 heart patients from 470 hospitals, and found more than half experienced cardiac arrest either on the weekend or after 11pm at night during the week.
Researchers found that the overall survival rate for all patients — regardless of when they head a heart attack — increased to 25.2 percent from 16 percent between 2000 and 2014. Weekend survival rates also rose from 11.9 percent to 21.9 percent, according to the new study.
But the gap between weekday and off-hours survival remained the same.
“Despite an overall improvement in survival, lower survival in IHCA (in-hospital cardiac arrest) during off-hours compared with on-hours persists,” the researchers concluded.
Dr. Seth Goldstein, a pediatric surgical fellow at Johns Hopkins University Hospital, tells Newsmax Health that for a number of conditions it is still true that one is more likely to die in the hospital on the weekend or overnight.
“It is a small but statistically significant risk, generally only seen when large numbers of patients and hospitals are pooled together,” Goldstein says.
He says one reason may be that sicker patients may come to a hospital over the weekend, or when staffing is generally lower than during weekdays.
“The sicker patients refers to the idea that folks are more reluctant to come wait in an ER on the weekend or don’t get referred promptly because their usual clinics are closed,” he notes.
“In addition, we know folks are doing more activities that can take them farther from home and tend to be more under the influence on the weekend.”
Dr. David Brownstein, a board-certified family physician and medical director for the Center for Holistic Medicine in West Bloomfield, Mich., tells Newsmax Health that hospitals can be dangerous places even when they’re fully staffed. He says mistakes in hospitals are one of the leading causes of illness and death.
Brownstein, a Newsmax contributor and editor of the Natural Way to Health newsletter, adds that things only get worse on holidays and weekends, making it important to have someone watching out for you when you are in the hospital, especially during low staffing shifts.
Goldstein says most research on the weekend effect focuses on the hospital-level factors like staffing levels, to the availability of ancillary services like phlebotomy and radiology, as well as emergency room wait times. But no single factor appears to account for the increased mortality risk.
“No hospital characteristics have been found to predict or mitigate the effect, so the presumption is that the cause is multifactorial,” he says.
Overall, Goldstein says the topic is difficult to study because hospitals do things differently, creating hundreds of factors that may play a role in mortality.
But he adds that there are lessons for the healthcare system to be learned from studies like the latest one.
“Specifically, mature state trauma networks and solid organ transplants seem less predisposed,” he says. “These are systems that have regionalization of care, specific provider education and are highly protocolized.”
Goldstein says getting the healthcare community to recognize the weekend effect is an appropriate first step toward further research that can benefit patients.
Although you may not be able to predict when you’re admitted to the hospital there are some things you can do to make your hospital stay as safe as possible. Experts advise:
Bring all your current medications, including over-the-counter medications, dietary supplements, and herbal remedies.
Follow your doctor’s advice prior to any surgical procedure.
Make sure everyone responsible for your care is aware of any allergies to medications.
Bring someone with you — a spouse, family member, or friend — who can advocate on your behalf. This person can be alert, ask questions, and help manage your care in the event you’re not feeling up to it
Ask questions. If you’re not sure about something, ask the doctor or nurse for clarification.
If you are elderly, use your call button to ask for help getting to the restroom or walking down the hallway to prevent a fall. Non-slip socks, often provided by the hospital, are another level of protection against falls. Talk to your healthcare team if you feel dizzy or unsteady.
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