WEEKEND admission has been linked to higher mortality risk and post-procedure morbidity amongst patients entering hospital for transjugular intrahepatic portosystemic shunt (TIPS), according to recent research. Renxi Li, George Washington University, Washington, D.C., USA, and team, found that individuals admitted over weekends for TIPS procedures exhibited higher incidences of mortality, hepatic encephalopathy, acute kidney injury, and transfers to alternate hospital facilities. They also experienced longer times from admission to surgery, extended hospital stays, and higher overall hospital costs.
TIPS is an interventional radiological procedure used to bypass the portal vein system. A stent is inserted a stent to connect the portal veins to adjacent blood vessels that have lower pressure, relieving the pressure of blood flowing through the diseased liver and can help stop bleeding and fluid backup. This can be a life-saving procedure for many patients with end-stage cirrhosis, however there is little data on how weekend admission could play a role in exacerbating complications from the procedure.
The study included data collected between 2015 and 2020 from 6,658 patients who underwent TIPS procedures. The team stratified the patients into 1,119 weekend patients and 5,539 weekday patients. Weekend patients had significantly higher in-hospital mortality, hepatic encephalopathy, acute kidney injury, and transfer-out risk compared with weekday patients, according to the results. Weekend patients had longer average wait times from admission to operation compared with weekday patients (3.8 days vs. 2.8 days, p < 0.01), and longer average lengths of stay (11.3 days vs. 8.4 days, p < 0.01). Weekend patients also had higher total hospital charges.
The authors emphasised the importance of eliminating delays tied to this weekend effect in order to help bridge gaps between treatment for weekend and weekday patients. “By addressing these issues, we can strive to deliver consistent and high-quality care to all patients, regardless of the day of admission,” the authors wrote.
Reference
Li R et al. Higher risk of in-hospital mortality and hepatic encephalopathy during weekend admission in transjugular intrahepatic portosystemic shunt procedure. Clin Res Hepatol Gastroenterol. 2024;48(7):102396.
