The impact of holiday season and weekend effect on traumatic injury mortality: Evidence from a 10-year analysis

Po-Chen Lin; Chi-Yuan Liu; I-Shiang Tzeng; Tsung-Han Hsieh; Chun-Yu Chang; Yueh-Tseng Hou; Yu-Long Chen; Da-Sen Chien; Giou-Teng Yiang; Meng-Yu Wu

doi:10.4103/tcmj.tcmj_20_22

The impact of holiday season and weekend effect on traumatic injury mortality: Evidence from a 10-year analysis

Tzu Chi Med J. 2022 Jul 26;35(1):69-77. doi: 10.4103/tcmj.tcmj_20_22. eCollection 2023 Jan-Mar.

Authors

Po-Chen Lin^{1

2}, Chi-Yuan Liu^{3

4}, I-Shiang Tzeng⁵, Tsung-Han Hsieh⁵, Chun-Yu Chang^{6

7}, Yueh-Tseng Hou^{1

2}, Yu-Long Chen^{1

2}, Da-Sen Chien^{1

2}, Giou-Teng Yiang^{1

2}, Meng-Yu Wu^{1

2}

Affiliations

¹ Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
² Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien, Taiwan.
³ Department of Orthopedic Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
⁴ Department of Orthopedics, School of Medicine, Tzu Chi University, Hualien, Taiwan.
⁵ Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
⁶ Department of Anesthesiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan.
⁷ Department of Anesthesiology, School of Medicine, Tzu Chi University, Hualien, Taiwan.

Abstract

Objectives: Trauma is one of the leading causes of death and its incidence increases annually. The "weekend effect" and "holiday season effect" on traumatic injury mortality remain controversial, whereby traumatic injury patients admitted during weekends and/or holiday season have a higher risk of in-hospital death. The present study is aimed to explore the association between "weekend effect" and "holiday season effect" and mortality in traumatic injury population.

Materials and methods: This retrospective descriptive study included patients from the Taipei Tzu Chi Hospital Trauma Database between January 2009 and June 2019. The exclusion criterion was age of < 20 years. The primary outcome was the in-hospital mortality rate. The secondary outcomes included intensive care unit (ICU) admission, ICU re-admission, length of stay (LOS) in the ICU, ICU admission duration ≥ 14 days, total hospital LOS, total hospital LOS ≥ 14 days, need for surgery, and re-operation rate.

Results: In this study, 11,946 patients were included in the analysis, and 8143 (68.2%) patients were admitted on weekdays, 3050 (25.5%) on weekends, and 753 (6.3%) on holidays. Multivariable logistic regression revealed that the admission day was not associated with an increased risk of in-hospital mortality. In other clinical outcome analyses, we found no significant increase in the risk of in-hospital mortality, ICU admission, ICU LOS ≥ 14 days, or total LOS ≥ 14 days in the weekend and holiday season groups. The subgroup analysis showed that the association between holiday season admission and in-hospital mortality was noted only in the elderly and shock condition populations. The holiday season duration did not differ in terms of in-hospital mortality. Longer holiday season duration was also not associated with an increased risk of in-hospital mortality, ICU LOS ≥14 days, and total LOS ≥14 days.

Conclusion: In this study, we did not find any evidence that weekend and holiday season admissions in the traumatic injury population were associated with an increased risk of mortality. In other clinical outcome analyses, there was no significant increase in the risk of in-hospital mortality, ICU admission, ICU LOS ≥ 14 days, or total LOS ≥ 14 days in the weekend and holiday season groups.

Keywords: Holiday season effect; Mortality; Trauma; Weekend effect.