Weekend versus Weekday Admission in Spinal Cord Injury and Its Effect on Timing of Surgical Intervention

Rafael De la Garza Ramos, Michael Longo, Yaroslav Gelfand, Murray Echt, Bassel G. Diebo, Neil V. Shah, Remi A. Kessler, Peter G. Passias, Reza Yassari

Research output: Contribution to journalArticle

Abstract

Objective: We sought to compare timing of intervention for patients with spinal cord injury (SCI) requiring surgical procedures during weekend versus weekday admissions. Methods: The National Inpatient Sample database from 2012 to 2014 was queried to identify patients with SCI who underwent surgical treatment (decompression with or without stabilization) as an emergent/urgent procedure. Timing of intervention, inpatient morbidity, and inpatient mortality were compared between patients admitted during the weekend versus a weekday. Multiple logistic regression analyses were also performed. Results: A total of 9390 patients were identified (mean age 55 years, 73.2% male) from the database, with 34.1% admitted during the weekend and 65.9% during a weekday. The average day of intervention for the entire cohort was 2.8 (SD 3.9, interquartile range 1–4); day 2.7 (standard deviation [SD] 4.0) versus day 2.8 ([SD] 3.9) for patients admitted in a weekend versus weekday (P = 0.418). After controlling for patient age, sex, and injury severity score on multiple logistic regression analysis, weekend admission was not significantly associated with early intervention (odds ratio [OR] 0.99; 95% confidence interval [CI], 0.82–1.21; P = 0.993), complication occurrence (OR 1.09; 95% CI, 0.86–1.38; P = 0.476), or inpatient mortality (OR 0.83; 95% CI, 0.44–1.56; P = 0.563). Patients with complete/American Spinal Injury Association A injuries were more likely to undergo early intervention (OR 2.09; 95% CI, 1.31–3.31; P = 0.002). Conclusion: In this national study, patients with SCI who were admitted during the weekend received surgical intervention as early as patients admitted during a weekday. Furthermore, no differences in complication or mortality rates between groups were found.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Spinal Cord Injuries
Inpatients
Odds Ratio
Confidence Intervals
Mortality
Logistic Models
Regression Analysis
Databases
Surgical Decompression
Injury Severity Score
Morbidity
Wounds and Injuries

Keywords

  • Complications
  • Outcomes
  • Spinal cord injury
  • Spinal fracture
  • Weekend

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Weekend versus Weekday Admission in Spinal Cord Injury and Its Effect on Timing of Surgical Intervention. / De la Garza Ramos, Rafael; Longo, Michael; Gelfand, Yaroslav; Echt, Murray; Diebo, Bassel G.; Shah, Neil V.; Kessler, Remi A.; Passias, Peter G.; Yassari, Reza.

In: World Neurosurgery, 01.01.2018.

Research output: Contribution to journalArticle

De la Garza Ramos, Rafael ; Longo, Michael ; Gelfand, Yaroslav ; Echt, Murray ; Diebo, Bassel G. ; Shah, Neil V. ; Kessler, Remi A. ; Passias, Peter G. ; Yassari, Reza. / Weekend versus Weekday Admission in Spinal Cord Injury and Its Effect on Timing of Surgical Intervention. In: World Neurosurgery. 2018.
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abstract = "Objective: We sought to compare timing of intervention for patients with spinal cord injury (SCI) requiring surgical procedures during weekend versus weekday admissions. Methods: The National Inpatient Sample database from 2012 to 2014 was queried to identify patients with SCI who underwent surgical treatment (decompression with or without stabilization) as an emergent/urgent procedure. Timing of intervention, inpatient morbidity, and inpatient mortality were compared between patients admitted during the weekend versus a weekday. Multiple logistic regression analyses were also performed. Results: A total of 9390 patients were identified (mean age 55 years, 73.2{\%} male) from the database, with 34.1{\%} admitted during the weekend and 65.9{\%} during a weekday. The average day of intervention for the entire cohort was 2.8 (SD 3.9, interquartile range 1–4); day 2.7 (standard deviation [SD] 4.0) versus day 2.8 ([SD] 3.9) for patients admitted in a weekend versus weekday (P = 0.418). After controlling for patient age, sex, and injury severity score on multiple logistic regression analysis, weekend admission was not significantly associated with early intervention (odds ratio [OR] 0.99; 95{\%} confidence interval [CI], 0.82–1.21; P = 0.993), complication occurrence (OR 1.09; 95{\%} CI, 0.86–1.38; P = 0.476), or inpatient mortality (OR 0.83; 95{\%} CI, 0.44–1.56; P = 0.563). Patients with complete/American Spinal Injury Association A injuries were more likely to undergo early intervention (OR 2.09; 95{\%} CI, 1.31–3.31; P = 0.002). Conclusion: In this national study, patients with SCI who were admitted during the weekend received surgical intervention as early as patients admitted during a weekday. Furthermore, no differences in complication or mortality rates between groups were found.",
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AU - De la Garza Ramos, Rafael

AU - Longo, Michael

AU - Gelfand, Yaroslav

AU - Echt, Murray

AU - Diebo, Bassel G.

AU - Shah, Neil V.

AU - Kessler, Remi A.

AU - Passias, Peter G.

AU - Yassari, Reza

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N2 - Objective: We sought to compare timing of intervention for patients with spinal cord injury (SCI) requiring surgical procedures during weekend versus weekday admissions. Methods: The National Inpatient Sample database from 2012 to 2014 was queried to identify patients with SCI who underwent surgical treatment (decompression with or without stabilization) as an emergent/urgent procedure. Timing of intervention, inpatient morbidity, and inpatient mortality were compared between patients admitted during the weekend versus a weekday. Multiple logistic regression analyses were also performed. Results: A total of 9390 patients were identified (mean age 55 years, 73.2% male) from the database, with 34.1% admitted during the weekend and 65.9% during a weekday. The average day of intervention for the entire cohort was 2.8 (SD 3.9, interquartile range 1–4); day 2.7 (standard deviation [SD] 4.0) versus day 2.8 ([SD] 3.9) for patients admitted in a weekend versus weekday (P = 0.418). After controlling for patient age, sex, and injury severity score on multiple logistic regression analysis, weekend admission was not significantly associated with early intervention (odds ratio [OR] 0.99; 95% confidence interval [CI], 0.82–1.21; P = 0.993), complication occurrence (OR 1.09; 95% CI, 0.86–1.38; P = 0.476), or inpatient mortality (OR 0.83; 95% CI, 0.44–1.56; P = 0.563). Patients with complete/American Spinal Injury Association A injuries were more likely to undergo early intervention (OR 2.09; 95% CI, 1.31–3.31; P = 0.002). Conclusion: In this national study, patients with SCI who were admitted during the weekend received surgical intervention as early as patients admitted during a weekday. Furthermore, no differences in complication or mortality rates between groups were found.

AB - Objective: We sought to compare timing of intervention for patients with spinal cord injury (SCI) requiring surgical procedures during weekend versus weekday admissions. Methods: The National Inpatient Sample database from 2012 to 2014 was queried to identify patients with SCI who underwent surgical treatment (decompression with or without stabilization) as an emergent/urgent procedure. Timing of intervention, inpatient morbidity, and inpatient mortality were compared between patients admitted during the weekend versus a weekday. Multiple logistic regression analyses were also performed. Results: A total of 9390 patients were identified (mean age 55 years, 73.2% male) from the database, with 34.1% admitted during the weekend and 65.9% during a weekday. The average day of intervention for the entire cohort was 2.8 (SD 3.9, interquartile range 1–4); day 2.7 (standard deviation [SD] 4.0) versus day 2.8 ([SD] 3.9) for patients admitted in a weekend versus weekday (P = 0.418). After controlling for patient age, sex, and injury severity score on multiple logistic regression analysis, weekend admission was not significantly associated with early intervention (odds ratio [OR] 0.99; 95% confidence interval [CI], 0.82–1.21; P = 0.993), complication occurrence (OR 1.09; 95% CI, 0.86–1.38; P = 0.476), or inpatient mortality (OR 0.83; 95% CI, 0.44–1.56; P = 0.563). Patients with complete/American Spinal Injury Association A injuries were more likely to undergo early intervention (OR 2.09; 95% CI, 1.31–3.31; P = 0.002). Conclusion: In this national study, patients with SCI who were admitted during the weekend received surgical intervention as early as patients admitted during a weekday. Furthermore, no differences in complication or mortality rates between groups were found.

KW - Complications

KW - Outcomes

KW - Spinal cord injury

KW - Spinal fracture

KW - Weekend

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