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Tarrash M, Sciandra C, Peyser A, Goldman RH, Mullin C. Weekday vs. weekend oocyte retrievals: is there a difference? HUM FERTIL 2023; 26:1368-1373. [PMID: 37102565 DOI: 10.1080/14647273.2023.2193908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 01/21/2023] [Indexed: 04/28/2023]
Abstract
The purpose of this study was to evaluate whether there is a difference in procedure duration and time spent in the post anaesthesia care unit (PACU) between weekday (WD) and weekend (WE) oocyte retrievals (ORs). This was a retrospective cohort study of patients compared and stratified based on number of oocytes retrieved (1-10, 11-20, and >20). Student's t-test and linear regression models were used to assess the relationship between AMH, BMI, and a number of oocytes retrieved with the duration of procedure and total time spent in the PACU. 664 patients underwent OR of which 578 met inclusion criteria and were analyzed. There were 501 WD OR cases (86%) and 77 (13%) WE ORs. When stratified by number of oocytes retrieved, there was no difference in procedure duration or PACU time between WD vs. WE OR. Longer procedure times were associated with higher BMI (p = 0.04), AMH (p = 0.01) and oocytes retrieved (p < 0.01). Increased PACU times positively correlated with the number of oocytes retrieved (p = 0.04), but not AMH or BMI. While BMI, AMH, and number of oocytes retrieved are associated with longer intra-operative and post-operative recovery times, there is no difference in procedure or recovery time when comparing WD vs. WE procedures.
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Affiliation(s)
- Miriam Tarrash
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Northwell Health, North Shore University Hospital, Manhasset, New York, United States
| | - Casey Sciandra
- New York Institute of Technology College of Osteopathic Medicine, United States
| | - Alexandra Peyser
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Northwell Health, North Shore University Hospital, Manhasset, New York, United States
| | - Randi H Goldman
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Northwell Health, North Shore University Hospital, Manhasset, New York, United States
| | - Christine Mullin
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Northwell Health, North Shore University Hospital, Manhasset, New York, United States
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Rai K, Douglas IS, Mehta AB. Association of Hospital Mortality With Initiation of Mechanical Ventilation on a Weekend: A Retrospective Cohort Study. J Intensive Care Med 2023; 38:1136-1142. [PMID: 37357730 DOI: 10.1177/08850666231185315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
RATIONALE Increased mortality in patients admitted to hospitals on weekends is a well-described phenomenon labeled the "weekend effect." Studies evaluating the weekend effect in intensive care units (ICUs) have arrived at conflicting results. Identifying a weekend effect for critically-ill patients may inform clinical care pathways and resource allocation. OBJECTIVES Determine the association of initiation of mechanical ventilation (MV) upon admission on a weekend versus weekday with hospital mortality. METHODS We conducted a retrospective cohort study of non-surgical adult patients using the California Patient Discharge Database from 2018 to 2019. We identified MV initiated on the day of admission and diagnoses using discharge billing codes. The primary exposure was admission and initiation of MV on a weekend versus weekday and the primary outcome was hospital mortality. Hierarchical logistic regression was used to determine the association between hospital mortality and MV initiation timing, adjusting for case-mix. RESULTS Among 90 288 admissions in 2018 and 2019 meeting inclusion criteria, 24 771 (27.5%) had MV initiated on weekends, while 65 517 (72.6%) had MV initiated on weekdays. Patient demographics and comorbidities were similar between groups. Chronic alcohol and substance use disorders, and acute intoxications and traumas were more prevalent among patients with MV initiated on weekends. No difference in hospital mortality was observed with initiation of MV on weekends versus weekdays (23.1% vs 22.8%, ARD = 0.3%, aOR = 1.02, 95% CI 0.98, 1.07). CONCLUSIONS Contrary to prior studies, no increased mortality was observed among newly admitted patients initiated on MV on weekends compared to weekdays. While weekend effects may exist in other settings, newly admitted patients likely have MV initiated in the emergency department or ICU, which tend to have more consistent staffing levels. Further research is needed to determine if care patterns in these units could be used as a model for units where weekend effects continue to impact outcomes.
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Affiliation(s)
- Karan Rai
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Ivor S Douglas
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Denver Health and Hospital Authority, Denver, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Anuj B Mehta
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Denver Health and Hospital Authority, Denver, CO, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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Gasperini G, Bouazzi L, Sanchez A, Marotte L, Kézachian L, Bellec G, Cazes N, Rosetti M, Bousquet C, Renard A, Sanchez S. Healthcare-associated adverse events and readmission to the emergency departments within seven days after a first consultation. Front Public Health 2023; 11:1189939. [PMID: 37483920 PMCID: PMC10359972 DOI: 10.3389/fpubh.2023.1189939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The use of emergency hospital service has become increasingly frequent with a rise of approximately 3.6%. in annual emergency department visits. The objective of this study was to describe the reasons for reconsultations to emergency departments and to identify the risk and protective factors of reconsultations linked to healthcare-associated adverse events. Materials and methods A retrospective, descriptive, multicenter study was performed in the emergency department of Troyes Hospital and the Sainte Anne Army Training Hospital in Toulon, France from January 1 to December 31, 2019. Patients over 18 years of age who returned to the emergency department for a reconsultation within 7 days were included. Healthcare-associated adverse events in the univariate analysis (p < 0.10) were introduced into a multivariate logistic regression model. Model performance was examined using the Hosmer-Lemeshow test and calculated with c-statistic. Results Weekend visits and performing radiology examinations were risk factors linked to healthcare associated adverse events. Biological examinations and the opinion of a specialist were protective factors. Discussion Numerous studies have reported that a first consultation occurring on a weekend is a reconsultation risk factor for healthcare-associated adverse events, however, performing radiology examinations were subjected to confusion bias. Patients having radiology examinations due to trauma-related pathologies were more apt for a reconsultation. Conclusion Our study supports the need for better emergency departments access to biological examinations and specialist second medical opinions. An appropriate patient to doctor ratio in hospital emergency departments may be necessary at all times.
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Affiliation(s)
- Guillaume Gasperini
- Emergency Hospital Services, Sainte Anne Army Training Hospital, Toulon, France
| | - Leila Bouazzi
- University Committee of Resources for Research in Health (CURRS), University of Reims Champagne-Ardenne, Reims, France
| | | | - Louis Marotte
- Emergency Hospital Services, Sainte Anne Army Training Hospital, Toulon, France
| | - Laury Kézachian
- Medical Educational Institute Les Farfadets, UGECAM PACA-Corse, La Valette-du-Var, France
| | - Guillaume Bellec
- Emergency Hospital Services, Sainte Anne Army Training Hospital, Toulon, France
| | - Nicolas Cazes
- Emergency Medical Aid Services, Battalion of Marine Firefighters of Marseille, Marseille, France
| | - Maxime Rosetti
- Emergency Hospital Services, Troyes Hospital, Troyes, France
| | - Claire Bousquet
- Emergency Hospital Services, Troyes Hospital, Troyes, France
| | - Aurélien Renard
- Emergency Medical Aid Services, Battalion of Marine Firefighters of Marseille, Marseille, France
| | - Stéphane Sanchez
- University Committee of Resources for Research in Health (CURRS), University of Reims Champagne-Ardenne, Reims, France
- Public Health and Performance Department, Champagne Sud Hospital, Troyes, France
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Impact of the day of the week on the discontinuation of broad-spectrum antibiotic prescriptions; a multi-centered observational study. Sci Rep 2021; 11:20784. [PMID: 34675236 PMCID: PMC8531020 DOI: 10.1038/s41598-021-00206-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 10/01/2021] [Indexed: 11/11/2022] Open
Abstract
To encourage and guide antimicrobial stewardship team (AST) activity and promote appropriate antibiotic use, we studied the impact of day of the week on the initiation and discontinuation of antibiotic administration. This was a multicenter observational study conducted at 8 Japanese hospitals from April 1 to September 30, 2019, targeting patients who underwent treatment with broad-spectrum antibiotics, such as anti-methicillin-resistant Staphylococcus aureus agents and anti-pseudomonal agents. We compared the weekly numbers of initiations and discontinuations of antibiotic prescription on each day of the week or on the days after a holiday. There was no statistical difference in the number of antibiotic initiations on both weekdays and the day after a holiday. However, antibiotic discontinuation was significantly higher from Tuesday onward than Monday and from the second day than the first day after a holiday. Similar trends were observed regardless of the categories of antibiotics, hospital and admission ward, and AST activity. This study suggests that broad-spectrum antibiotics tend to be continued during weekends and holidays and are most likely to be discontinued on Tuesday or the second day after a holiday. This was probably due to behavioral factors beyond medical indications, requiring further antimicrobial stewardship efforts in the future.
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Meng N, Ye Z, Liu Y, Qin C, Su Y. Impact of the 'weekend effect' on hospital-acquired pneumonia after aneurysmal subarachnoid hemorrhage. Postgrad Med 2021; 133:974-978. [PMID: 34323649 DOI: 10.1080/00325481.2021.1959936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Weekend admission has been reported to be associated with poor clinical outcomes of various diseases. This study aimed to determine whether weekend admission increases the incidence of hospital-acquired pneumonia (HAP) in patients with aneurysmal subarachnoid hemorrhage (aSAH). METHODS We retrospectively analyzed aSAH patients admitted to our hospital between 2014 and 2020. These patients were divided into weekend and weekday groups. We compared the incidence of HAP and other clinical outcomes between the two groups. Risk factors for HAP were identified by logistic regression analysis. RESULTS Of 653 included aSAH patients, 145 (22%) were admitted on weekends and 508 (78%) were admitted on weekdays. The incidence of HAP in the weekend group was significantly higher than that in the weekday group (25% vs 16%, P = 0.01). The weekend group showed worse clinical outcomes, including worse neurological outcome (74% vs 65%, P = 0.03), higher risk of intensive care unit (ICU) admission (21% vs 13%, P = 0.01) and longer length of stay (21.3 vs 16.4 days, P < 0.01). Age ≥ 60 years (odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.3-3.0, P < 0.01), modified Fisher score (MFS) ≥ 3 (OR = 1.7, 95% CI = 1.1-2.6, P = 0.02), weekend admission (OR = 1.8, 95% CI = 1.1-2.8, P = 0.02) and operative treatment (OR = 2.3, 95% CI = 1.2-4.5, P = 0.02) were risk factors for HAP following aSAH. CONCLUSION Weekend admission was associated with a higher incidence of HAP in aSAH patients. This study suggested that medical administrators may need to optimize healthcare services on weekends.
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Affiliation(s)
- Ningqin Meng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ziming Ye
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ying Liu
- Department of Rehabilitation, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chao Qin
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Ying Su
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Volovici V, Dammers R, Meling TR. The "weekend effect" and outcomes after clipping of ruptured intracranial aneurysms-general healthcare metrics and trained vascular neurosurgeons. Acta Neurochir (Wien) 2021; 163:793-795. [PMID: 33389120 DOI: 10.1007/s00701-020-04690-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Victor Volovici
- Department of Neurosurgery, Erasmus MC Stroke Center, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - Ruben Dammers
- Department of Neurosurgery, Erasmus MC Stroke Center, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Torstein R Meling
- Neurosurgery Division, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Fan X, Zhang K, Wang X, Zhang X, Zeng L, Li N, Han Q, Liu Z. Sleep disorders are associated with acetaminophen-induced adverse reactions and liver injury. Biomed Pharmacother 2021; 134:111150. [PMID: 33395599 DOI: 10.1016/j.biopha.2020.111150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/03/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022] Open
Abstract
Risk factors related to the development of acetaminophen (APAP)-induced adverse reactions and liver injury remain uncertain. Sleep disorders have been linked to some health outcomes. This study examined the associations of sleep disorders with APAP-induced adverse reactions or liver injury and the possible mechanisms. From NIS database, adverse reactions, liver injury and sleep disorders were identified. Factors associated with the risk of the total adverse effects or liver injury were examined with logistic regression. From Gene Expression Omnibus database, datasets GSE111828, containing transcriptome data based on RNA-seq analysis from liver samples extracted from mice post APAP administration, and GSE92913, containing transcriptome data based on microarray analysis from liver samples extracted from mice with sleep deprivation, were analyzed. A total of 4372754 patients without and 91314 patients with sleep disorders were eligible for analyses. Both before and after propensity score matching, APAP-induced adverse reactions were higher in patients with sleep disorders than in patients without. In multivariate regression, sleep disorders were associated with higher odds of APAP-induced adverse reactions (adjusted OR [aOR] 2.005, 95 % CI 1.343-2.995) and liver injury (aOR 2.788, 95 % CI 1.310-5.932). Genes that were enriched in bile secretion and retinol metabolism and PPAR signaling pathways were basically down-regulated in livers of mice after APAP administration and livers of mice with sleep deprivation. This study shows that sleep disorders may be novel independent risk factors for APAP-associated adverse reactions and liver injury and provides bioinformation linking sleep disorders to increased risk of APAP-induced liver injury.
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Affiliation(s)
- Xiude Fan
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Kun Zhang
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Xiaoyun Wang
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Xiaoge Zhang
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Lu Zeng
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Na Li
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Qunying Han
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China
| | - Zhengwen Liu
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China.
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Moosdorf R. „Wochenendeffekt“ bei nichtelektiven Bypass-Operationen. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2020. [DOI: 10.1007/s00398-020-00374-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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