SUN-837 - The Weekend Effect in Endocrine Emergencies in the United States: A Nationwide Analysis (2016-2021)

Title

The Weekend Effect in Endocrine Emergencies in the United States: A Nationwide Analysis (2016–2021)

Background

The “weekend effect,” defined as worse outcomes among patients admitted on weekends, has been reported in several acute medical conditions but remains poorly characterized in endocrine emergencies. We examined whether weekend admission is associated with adverse in-hospital outcomes among patients hospitalized for endocrine emergencies.

Methods

We conducted a retrospective cohort study using the National Inpatient Sample from 2016–2021. Adult hospitalizations with a primary diagnosis of diabetic ketoacidosis, severe hypoglycemia, thyroid storm, myxedema coma, or adrenal crisis were identified and classified by admission day (weekend vs weekday). The primary outcome was in-hospital mortality; secondary outcomes included length of stay (LOS) and total hospital cost. Multivariable logistic and linear regression models adjusted for age, sex, race, median household income, Charlson Comorbidity Index, hospital teaching status, hospital region, and insurance type.

Results

A total of 1,127,655 hospitalizations were analyzed, of which 27% occurred on weekends. Diabetic ketoacidosis accounted for the majority of admissions. In unadjusted analyses, weekend admission was not significantly associated with in-hospital mortality (OR 1.10; 95% CI 0.98–1.24; p=0.10). After adjustment, weekend admission was associated with higher odds of in-hospital death (adjusted OR 1.15; 95% CI 1.01–1.30; p=0.03). No significant differences were observed in adjusted LOS or total hospital cost.

Conclusion

Weekend admission for endocrine emergencies is associated with a modest but significant increase in in-hospital mortality despite similar healthcare utilization. These findings suggest potential gaps in weekend care delivery and highlight opportunities for targeted quality improvement initiatives to ensure consistent care across admission days.

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