Association between nighttime/weekend visits and patient outcomes in children with blunt liver and spleen injuries

• Published in: Pediatric surgery international 2024-11, Vol.41 (1), p.5, Article 5
• Main Authors: Funakoshi, Hiraku, Shirane, Shogo, Katsura, Morihito
• Format: Article
• Language: English
• Subjects: Abdominal Injuries - mortality; Abdominal Injuries - therapy; Adolescent; After-Hours Care - statistics & numerical data; Child; Child, Preschool; Female; Humans; Infant; Liver - injuries; Male; Medicine; Medicine & Public Health; Mortality; Original Article; Patients; Pediatric Surgery; Pediatrics; Republic of Korea - epidemiology; Retrospective Studies; Spleen - injuries; Surgery; Time Factors; Trauma; Wounds, Nonpenetrating - mortality; Wounds, Nonpenetrating - therapy
• ISSN: 1437-9813; 0179-0358; 1437-9813
• DOI: 10.1007/s00383-024-05895-7

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.