{
  "abstract": "Background The presence of a ‘weekend effect’ in aneurysmal subarachnoid hemorrhage (aSAH) remains controversial, particularly in the contemporary era of advanced neurocritical care and endovascular therapy. We evaluated whether weekend admission was associated with worse in-hospital mortality among patients hospitalized with treated aSAH in the United States.Methods We used the 2018-2022 National Inpatient Sample to identify adult hospitalizations with a principal diagnosis of intracranial aneurysm and non-traumatic subarachnoid hemorrhage who underwent aneurysm treatment. For this analysis, we examined the endovascularly treated cohort, including patients managed with coiling or flow-diverter-based therapy. The primary exposure was weekend versus weekday admission, and the primary outcome was in-hospital mortality. Survey weights were applied to generate national estimates. Crude outcomes were compared by admission day, and Complex Samples logistic regression was used for unadjusted and fully adjusted analyses.Results We identified 99,385 weighted discharges of endovascularly treated aSAH patients during the study period. Of these, 73,450 (73.9%) were admitted on weekdays and 25,935 (26.1%) on weekends. Overall, 18,595 in-hospital deaths occurred, corresponding to an overall mortality of 18.7%. Among weekday admissions, 13,600 patients died (18.5%) and 59,850 survived (81.5%). Among weekend admissions, 4,995 patients died (19.3%) and 20,940 survived (80.7%). Thus, crude mortality was numerically higher for weekend admissions (19.3% vs 18.5%), although the absolute difference was small. In unadjusted regression, weekend admission was not significantly associated with higher mortality (OR 1.05, 95% CI 0.97-1.14; p=0.24). After adjustment for sex, age, APR-DRG risk of mortality, APR-DRG severity of illness, hospital bed size, hospital teaching/location status, region, control/ownership, treatment modality, and calendar year, weekend admission remained non-significantly associated with mortality (adjusted OR 1.27, 95% CI 0.92-1.75; p=0.14).Conclusions In this large national cohort of endovascularly treated aSAH, weekend admission was not independently associated with higher in-hospital mortality. Although mortality was slightly higher among weekend admissions, the difference did not reach statistical significance after adjustment, suggesting that contemporary systems of care may help reduce the classic weekend effect in aSAH.Disclosures K. Gupta: None. M. Karsy: None. D. Altschul: None.Abstract E-323 Table 1Key findings for weekend versus weekday admission among endovascularly treated aneurysmal subarachnoid haemorrhage patients, NIS 2018-2022",
  "authors": [
    {
      "affiliations": [
        "The Leo M. Davidoff Department of Neurological Surgery Team, Albert Einstein School of Medicine, Bronx, NY"
      ],
      "name": "K Gupta"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Michigan, Lansing, MI"
      ],
      "name": "M Karsy"
    },
    {
      "affiliations": [
        "Neurosurgery, University of Florida, Gainesville, FL"
      ],
      "name": "B Lucke-Wold"
    },
    {
      "affiliations": [
        "The Leo M. Davidoff Department of Neurological Surgery Team, Albert Einstein School of Medicine, Bronx, NY"
      ],
      "name": "D Altschul"
    }
  ],
  "title": "E-323 Weekend admission and in-hospital mortality in treated aneurysmal subarachnoid hemorrhage: a national inpatient sample analysis, 2018-2022",
  "uid": "34ba38e3-db3c-584e-932f-97b936548993"
}