November 23, 2010

Weekend Hospital Stays Worsen Kidney Disease

(Ivanhoe Newswire) -- Patients with end-stage renal disease (ESRD) who are admitted to the hospital during the weekend are at increased risk of death, according to this study.

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

The researchers used the national hospital database and compared mortality rates and other hospital outcomes for ESRD patients hospitalized on weekends rather than weekdays. There were more than 800,000 ESRD admissions during 2007, and about 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, one-third of a day longer than patients admitted on weekdays,  to the start of dialysis treatment.
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."

SOURCE: American Society of Nephrology's 43rd Annual Meeting and Scientific Exposition held in Denver, CO from November 16-21