SUN-865 - Weekend vs. Weekday Hospitalization Outcomes in Endocrine Emergencies: A Nationwide Readmissions Database Analysis (2016-2022)

Background: Endocrine emergencies, such as thyroid storm, myxedema coma, and adrenal crisis, require prompt recognition and urgent management to prevent significant morbidity and mortality. However, limited data exist regarding whether a “weekend effect” influences outcomes in these conditions.

Methods: We utilized data from the Nationwide Readmissions Database (NRD) from 2016-2022 to identify patients hospitalized with endocrine emergencies including thyroid storm, myxedema coma, and adrenal crisis. We used NRD-predefined admission days to find whether the admission was on weekends or weekdays. The primary outcome was in-hospital all-cause mortality. Secondary outcomes included renal complications, hospital length of stay (LOS), total costs, and discharge disposition. Multivariable logistic regression analysis and propensity score matching were used to adjust for potential confounders.

Results: A total of 87,077 weighted hospitalizations for endocrine emergencies between 2016–2022 were identified, including thyroid storm (27%, n=23,623), myxedema coma (25%, n=21,671), and adrenal crisis (48%, n=41,783). After propensity score matching, in-hospital mortality did not differ between weekend vs. weekday admissions in all three endocrine emergencies (6.2% vs. 6.1%, p=0.89 for thyroid storm; 17.9% vs. 17.9%, p>0.99 for myxedema coma; 5.6% vs. 5.6%, p=0.90 for adrenal crisis). Similarly, hospital LOS, total costs and renal complications were similar between weekend vs. weekday admissions in all 3 endocrine emergencies. Among hospitalizations for adrenal crisis, weekend admissions were associated with higher rates of discharge to a facility (17.6% vs 15.7%, p=0.02) compared to weekday admissions. In contrast, discharge disposition did not differ significantly between weekend vs. weekday admissions among thyroid storm and myxedema coma hospitalizations.

Conclusion: Weekend admission was not associated with increased in-hospital mortality among patients with thyroid storm, myxedema coma, or adrenal crisis. Weekend admission in adrenal crisis was associated with a higher likelihood of discharge to a facility. These findings suggest that inpatient care for endocrine emergencies remains largely consistent across admission days, with limited evidence of a clinically meaningful weekend effect.

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