Potentially preventable complications in epilepsy admissions: The “weekend effect”

- Weekend epilepsy admissions had higher rates of hospital-acquired conditions (HAC).
- Mortality rates were higher for weekend epilepsy admissions compared to weekday.
- Higher inpatient charges were associated with HAC occurrence in patients with epilepsy.
- Prolonged length of stay was associated with HAC occurrence in patients with epilepsy.
- Higher inpatient mortality was associated with HAC occurrence in patients with epilepsy.

IntroductionEpilepsy affects approximately 1% of the population in the United States with frequent hospital admissions accounting for a significant burden on patients and society as a whole. Weekend admissions have generally been found to have poorer outcomes compared to weekday admissions with increased rates of preventable complications, such as nationally identified “hospital-acquired conditions” (HAC).ObjectiveThis study aimed to assess the impact of weekend admission on HACs and mortality in the adult epilepsy population.ParticipantsAll adult patients with epilepsy hospitalized in the U.S. from 2000 to 2010 in the Nationwide Inpatient Sample.ResultsThere were 12,997,181 admissions for epilepsy with 10,106,152 (78%) weekday, 2,891,019 (22%) weekend, and 10 (< 0.1%) missing admissions. Weekend admissions saw a 10% increased likelihood of both HACs (RR = 1.10, 95% CI:1.09, 1.11, p < 0.01) and mortality (RR = 1.10, 95% CI: 1.09, 1.11, p < 0.01) compared to weekday admissions. The occurrence of HAC was associated with higher inpatient charges (RR = 1.36, 95% CI: 1.35, 1.36, p < 0.01), pLOS (RR = 1.21, 95% CI: 1.21, 1.22, p < 0.01), and higher mortality (RR = 1.13, 95% CI: 1.12, 1.14, p < 0.01).ConclusionPrior studies have shown weekend admissions are usually associated with higher rates of complications leading to higher costs and a longer hospital stay. Likewise, weekend admissions for epilepsy were associated with increased rates of HACs and mortality; however, they were also negatively associated with LOS and total charge. Thus, weekend admissions for epilepsy should be considered high risk with greater effort made to mitigate these risks.