Is There a Weekend Effect in Orbital Fracture Management?
Austin D. Chen, Anmol S. Chattha, Alexandra Bucknor, Masoud Malyar, Anna Rose Johnson, Bernard T. Lee, Samuel J. Lin
Beth Israel Deaconess Medical Center, Boston, MA, USA
Background: The aim of this study is to report on whether a "weekend effect" is observed in patients who underwent orbital floor fracture management using the National Inpatient Sample database.
Methods: Patients who underwent primary treatment for emergent isolated orbital fractures were retrieved from the National Inpatient Sample (2008-2012) using International Classification of Diseases 9th edition codes and sub-grouped into weekday and weekend admissions. Patient and hospital characteristics were analyzed using the Pearson χ2 or Fisher's exact test and the Wilcoxon-Mann-Whitney test. Time to procedure, length of stay, inpatient charges, mortality and morbidity were analyzed using multiple logistic regressions and multiple linear regressions.
Results: Between 2008-2012, 3,073 patients who underwent primary treatment for emergent isolated orbital fracture were identified. A greater number of patients were admitted on weekends than weekdays were treated multiple days after admission (28.6% vs. 21.8%, p<0.001). Analysis of mortality (0.4% vs. 0.4%, p=0.863), length of stay (3.23 ± 2.58 vs. 3.58 ± 3.31 days, p=0.580) and inpatient charges ($42014.39 ± $35410.90 vs. $42244.85 ± $33520.92, p=0.141) revealed no differences. Enophthalmos rates (2.9% vs. 1.8%, p=0.034) were greater on weekdays and orbital infection rates (0.8% vs. 0.5%, p=0.003) were greater on weekends.
Conclusion: Weekend admissions were more likely to develop orbital infections and undergo delayed procedures. Mortality, length of stay, inpatient charges and other complications did not support the weekend effect. It is likely that our results are multifactorial and may also be related to surgical specialty, level of medical or surgical training, or other intangible factors.
Back to 2017 Posters
