Is there a weekend effect in severe traumatic brain Injury? An observational, population-based study from the Norwegian Trauma registry.

Introduction: Traumatic brain injury is prevalent and with severe injury the mortality is high. The aim of this study was to explore differences in mortality rates between weekday and weekend admissions for patients with severe traumatic brain injury (TBI) in Norway based on data from the National Trauma Registry of Norway (NTR). Research question: Are mortality rates higher for patients with severe traumatic brain injury admitted on weekends compared to weekdays? Materials and methods: This study is an observational cohort study based on prospectively collected, population-based data from the NTR. The study period was between January 01, 2017 and December 31, 2020 and included all patients with severe TBI registered in the database. Results: During the 4 years-study period 627 patients with severe TBI were identified; the median age was 53.0 years (IQR 32.0-71.0). Weekend admissions involved significantly younger patients with a median age of 50.0 years compared to a median age of 57.0 years on weekdays (p = 0.013). Overall, the 30-day mortality rate was 39 %, with higher mortality observed on weekdays compared to weekends (43 % vs. 34 %; p = 0.025). Logistic regression analysis showed that age and higher AIS head injury severity were significantly associated with 30-day mortality, while admission timing (weekend vs. weekday) showed no association. Discussion and conclusion: Weekend admissions in severe TBI are frequent and involves younger patients compared to weekdays. Our study did not find a weekend effect on the mortality rate for severe TBI in Norway based on data from the NTR.