Weekend admission for cervical spinal cord injury associated with shorter length of stay at private non-profit centers

Objective

We assessed if weekend versus weekday admission for cervical spinal cord injury (CSCI) influenced medical comorbidities, length of stay, and mortality while also exploring the role of hospital-specific factors.

Methods

The National Inpatient Sample (2015–2020) was queried for patients with CSCI. Propensity score matching (PSM) controlled for age, gender, hospital region, and illness severity, matching weekend admissions in a 1:1 ratio with weekday admissions. Parametric statistical tests then compared clinical and hospital-specific factors.

Results

5036 patients were analyzed (mean age 56, 24 % female). Weekend admissions showed no increase in mortality (p = 0.305) despite a higher likelihood of shock (p = 0.0154), cervical fractures (p = 0.0408), and ventilatory support requirements (p < 0.001). Patients with spinal fractures had higher mortality than those with non-spinal fractures (p < 0.001). After stratification by weekend status, hospital ownership/control and hospital location/teaching status were significantly correlated with length of stay (p < 0.001, p = 0.0276, respectively). Private non-profit hospitals showed a shorter length of stay for weekend admissions (p = 0.00573), though fewer were discharged directly home (p = 0.0314). There was a weak association between payer type and disposition (Cramér's V = 0.146, p < 0.001).

Conclusion

This national retrospective study revealed no difference in overall mortality rates between weekend and weekday admissions for patients presenting with CSCI. In patients with associated fractures, spinal fractures showed higher mortality rates than non-spinal fractures. Decreased length of stay was associated with weekend admissions to private non-profit centers, with no difference in mortality rates in this cohort.