Weekend effect found in urgent pediatric IBD hospitalizations

Takeaway

• For children with IBD who experience urgent hospitalization followed by surgery, the risk for surgical complications is considerably higher with weekend admission.
• ED stabilization may be protective.

Why this matters

• The “weekend effect” has been noted in a number of settings and clinical situations, including the ICU, upper gastrointestinal bleeding, emergency general surgery, and gastrointestinal surgery.
• Few data address IBD populations.

Key results

• Crohn’s disease, complication rate:
  • Weekend vs weekday:
    • 16% vs 12% (P=.004);
    • OR, 1.3 (95% CI, 1.0-1.7).
  • Urban nonteaching vs urban teaching hospital:
    • OR, 2.2 (95% CI, 1.6-2.8).
• Ulcerative colitis, complication rate:
  • Weekend vs weekday:
    • 16% vs 9% (P<.001);
    • OR, 1.7 (95% CI, 1.2-2.3).
  • ED vs non-ED admissions:
    • OR, 0.4 (95% CI, 0.3-0.5).

Study design

• Cross-sectional study of children with IBD age ≤18 years with urgent, nonelective hospitalizations recorded in the large, all-payor Kids’ Inpatient Database (KID; n=3255 hospitalizations).
• Participants had all undergone surgery within 48 hours of admission.
• Authors compared weekend vs weekday hospitalizations.
• Outcome: composite of in-hospital complications.
• Funding: NIH.

Limitations

• Potential confounders because of lack of data on, e.g.,  disease severity, trainee involvement.