RT Journal
A1 Carr BG, Reilly PM, Schwab C, Branas CC, Geiger J, Wiebe DJ
T1 WEekend and night outcomes in a statewide trauma system
JF Archives of Surgery
JO Archives of Surgery
YR 2011
FD July 1
VO 146
IS 7
SP 810
OP 817
DO 10.1001/archsurg.2011.60
UL http://dx.doi.org/10.1001/archsurg.2011.60
AB Objective 
                  To evaluate whether mortality and clinical outcomes vary for injured patients in a mature trauma system on weeknights and weekends compared with weekdays.Design 
                  Retrospective cohort study.Setting 
                  Pennsylvania trauma system.Patients 
                  A total of 90 461 patients over 5 years.Intervention 
                  Treatment at a level I, II, or III trauma center.Main Outcome Measures 
                  In-hospital mortality, time to procedures, and length of stay.Results 
                  In adjusted analyses, patients presenting on weeknights were no more likely to die than patients presenting during weekdays, and patients presenting on weekends were less likely to die than patients presenting on weekdays (odds ratio = 0.89; 95% confidence interval, 0.81-0.97). Presenting on weeknights was associated with longer intensive care unit stay (incidence rate ratio = 1.06; 95% confidence interval, 1.02-1.10) and longer hospital stay (incidence rate ratio = 1.02; 95% confidence interval, 1.00-1.04). Presenting on weekends was associated with longer intensive care unit stay (incidence rate ratio = 1.04; 95% confidence interval, 1.02-1.10) but not longer hospital stay. Delays to laparotomy or craniotomy were not seen in either group.Conclusions 
                  We demonstrate comparable mortality among injured patients presenting on weeknights vs weekdays and lower mortality among injured patients on weekends vs weekdays. Systems-based solutions of the trauma model are protective against the weekend effect and inform care for other emergency care–sensitive conditions.