Weekend hospital admission increases risk for mortality in HCC

Patients with hepatocellular carcinoma admitted to the hospital on the weekend had an increased likelihood for mortality vs. patients admitted on a weekday, according to data presented at the Society of Hospital Medicine Annual Meeting 2016.

Using the Nationwide Inpatient Sample database, researchers, including Ngozi Yvonne Enwerem, MD, of Howard University Hospital in Washington, D.C., evaluated 6,641 patients with hepatocellular carcinoma (HCC) admitted to the hospital on a weekend from 2001 to 2010. All patients were 21 years of age or older and had urgent or emergent types of admission during this time.

“Patients with hepatocellular carcinoma are frequently hospitalized emergently. Studies that describe the factors associated with HCC-related mortality during hospitalizations are limited; [therefore], we sought to use a nationally representative database to investigate whether a weekend versus non-weekend admission was associated with increased odds of mortality in hospitalized patients with HCC,” the researchers wrote.

Multivariable logistic regression analysis showed that patients admitted during a weekend had an equal likelihood of undergoing a procedure compared with patients admitted on a weekday (adjusted OR = 0.99; 95% CI, 0.9-1.09). However, patients admitted on the weekend had an increased likelihood of mortality compared with patients admitted on a weekday (OR = 1.17; 95% CI, 1.08-0.28).

Further analysis showed female gender (OR = 0.89; 95% CI, 0.82-0.97), a teaching hospital (OR = 0.86; 95% CI, 0.76-0.96) and urban location (OR = 0.73; 95% CI, 0.6-0.87) were associated with reduced likelihood of mortality. Patients who were black (OR = 1.14; 95% CI, 1-1.29) or of Asian/Pacific Island descent (OR = 1.23; 95% CI, 1.04-1.47) had increased overall mortality compared with Caucasian patients.

The researchers concluded: “Among emergently hospitalized patients with HCC, weekend admission is associated with an increased odds of mortality. Studies are needed to define the factors that increase the risk for death in HCC patients hospitalized during the weekend.” – by Melinda Stevens

Reference:

Enwerem NY, et al. Abstract #108. Presented at: Society of Hospital Medicine Annual Meeting; March 6-9, 2016; San Diego.

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