Is there a weekend effect on mortality rate and outcome for moderate and severe traumatic brain injury? A population-based, observational cohort study

Abstract

Purpose The aim of the study was to analyse patient and injury characteristics and the effects of weekend admissions on mortality rate and outcome after moderate and severe traumatic brain injuries.

Methods This is an observational cohort study based on data from a prospectively maintained regional trauma registry in South Western Norway. Patients with moderate and severe traumatic brain injury admitted between January 1st, 2004 and December 31st, 2019 were included in this study.

Results During the study period 688 patients were included in the study with similar distribution between moderate (n ​= ​318) and severe (n ​= ​370) traumatic brain injury. Mortality rate was 46% in severe and 13% in moderate traumatic brain injury. Two hundred and thirty-one (34%) patients were admitted during weekends. Patients admitted during weekends were significantly younger (median age (IQR) 32.0 (25.5–67.0) vs 47.0 (20.0–55.0), p ​< ​0.001). Pre-injury ASA 1 was significantly more common in patients admitted during weekends (n ​= ​146, 64%, p ​= ​0.001) while ASA 3 showed significance during weekdays compared to weekends (n ​= ​101, 22%, p ​= ​0.013). On binominal logistic regression analysis mortality rate was significantly higher with older age (OR 1.03, 95% CI for OR 1.02–1.04, p ​< ​0.001) and increasing TBI severity (OR 7.08, 95% CI for OR 4.67–10.73, p ​< ​0.001).

Conclusions Mortality rate and poor clinical outcome remain high in severe traumatic brain injury. While a higher number of patients are admitted during the weekend, mortality rate does not differ from weekday admissions.