Association between nighttime/weekend visits and patient outcomes in children with blunt liver and spleen injuries
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In brief
In brief
This nationwide multicenter study examined whether nighttime or weekend hospital admissions affect outcomes in children with blunt liver and spleen injuries. Analysis of 1,414 pediatric trauma patients found no significant differences in intervention rates, mortality, or time to treatment between out-of-hours and weekday admissions.
- No 'out-of-hours effect' found in pediatric blunt liver/spleen injuries—weekend/nighttime admissions had similar intervention rates as weekday.
- 30-day mortality rates were comparable regardless of admission timing in 1414 pediatric BLSI cases across Japanese trauma centers (2008-2019).
- Time to first intervention showed no significant delay for children admitted during nights/weekends versus daytime/weekdays.
- Pediatric trauma systems may maintain consistent care quality for BLSI around the clock, unlike some adult medical conditions.
- Non-operative management protocols for pediatric BLSI appear robust enough to avoid timing-related outcome disparities.
Written by the GCMD Library team from the article.
Abstract
Purpose
The “out-of-hours effect,” which indicates hospital admittance during weekends or nighttime, has poorer outcomes for patients than for those admitted on weekdays and is widely documented in various medical conditions. However, this effect remains understudied in pediatric trauma cases, including blunt liver and spleen injuries (BLSIs).
Methods
This was a secondary analysis of a nationwide multicenter retrospective study, focusing on pediatric patients with trauma (≤ 16 years old) with BLSI admitted from 2008 to 2019. This study evaluated the association between out-of-hour admissions and outcomes. The primary outcome was the intervention rate and secondary outcomes were 30-day mortality and time from hospital arrival to the first intervention.
Results
This study identified 1414 pediatric patients with BLSI. In total, 681 events occurred during the daytime and 733 during the nighttime, with 927 weekday and 487 weekend events. Out-of-hour admissions did not significantly associate with a higher rate of intervention. This association remained after adjusting for five potential confounders and patient clustering within the hospital. In addition, Out-of-hour admissions did not significantly associated with 30-day mortality, or time from hospital arrival to the first intervention.
Conclusions
The current study showed no significant difference in treatment strategy and outcomes between weekday and out-of-hour among children with BLSI.