Weekend hospital stays worse for kidney patients

'Weekend effect' linked to delayed dialysis, higher risk of death

2010-11-19

(Press-News.org) Patients with end-stage renal disease (ESRD) who are admitted to the hospital during the weekend are at increased risk of death, according to a study presented at the American Society of Nephrology's 43rd Annual Meeting and Scientific Exposition.

"Our study highlights poor outcomes for patients with ESRD admitted over the weekend," comments Ankit Sakhuja, MD, a third year resident in internal medicine at The Medical College of Wisconsin, Milwaukee. "Further research is needed to identify the reasons for this 'weekend effect' and to institute appropriate interventions."

Using a national hospital database, researchers compared mortality rates and other hospital outcomes for ESRD patients hospitalized on weekends versus weekdays. There were more than 800,000 ESRD admissions during 2007, with nearly one fifth admitted over the weekend.

The mortality rate for ESRD patients admitted on weekends was significantly higher than those admitted on weekdays. With adjustment for other factors—including other medical conditions and hospital characteristics—patients admitted on weekends were 17% more likely to die in the hospital compared to patients admitted during the week.

Patients admitted on weekends also experienced delays to the start of dialysis treatment: nearly one-third of a day longer than for patients admitted on weekdays.

Reduced hospital staffing and limited resources on weekends may affect the quality of care. "Weekend effects have been shown in many diseases, including acute myocardial infarction and acute renal failure," according to Dr. Sakhuja.

The results show a similar weekend effect for ESRD patients, including delays to the start of dialysis treatment. "The restricted dialysis services on weekends may result in delayed care of the fluid and electrolyte imbalances, which can result in higher mortality," says Dr. Sakhuja. "Our study stresses the need to redesign hospital staffing models to assure improved staff and dialysis availability for patients dependent on dialysis over the weekends."

The authors note that their study was based on an administrative database prone to coding errors. Because of the nature of the data, it was not possible to ascertain the reasons for poorer outcomes of dialysis-dependent patients admitted over the weekends.

INFORMATION: Study co-authors include Nilay Kumar, MD, Rahul Nanchal, MD, Aaron Dall, MD, and Gagan Kumar, MD, all with The Medical College of Wisconsin.

Disclosures: The authors reported no financial disclosures.

The study abstract, "Weekend Admissions Predict Higher Mortality in Patients with End Stage Renal Disease," [TH-FC045] will be presented as an oral presentation on Thursday, November 18 at 5:18 PM in Room 203 of the Colorado Convention Center in Denver, CO.

ASN Renal Week 2010, the largest nephrology meeting of its kind, will provide a forum for 13,000 professionals to discuss the latest findings in renal research and engage in educational sessions related to advances in the care of patients with kidney and related disorders. Renal Week 2010 will take place November 16 – November 21 at the Colorado Convention Center in Denver, CO.

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, the American Society of Nephrology (ASN) is the world's largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.

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Weekend hospital stays worse for kidney patients

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