Does weekend and out-of-hour duty affect the outcome of neurological emergencies in children? – A prospective observational study from Southern Nigeria

Abstract

There is a growing body of literature that suggests increased rates of morbidity and mortality for pediatric conditions admitted on a weekend compared with weekdays. Whether this association is seen in Nigerian children presenting with neurologic emergencies is not certain. Understanding the effect of weekend admission on the outcome of pediatric neurologic emergencies is important to allocate personnel and resources more efficiently. This study was conducted to determine whether weekend and out-of-hour duty affect the outcome of neurological emergencies in children. This study used a cross-sectional analytic design over an 18-month period. Children aged 1 month–18 years presenting with neurologic emergencies were prospectively recruited over an 18-month period. The association between the dependent variable and independent variables was tested using the Chi-squared test and odds ratio. The level of statistical significance was accepted as P < 0.05. A total of 146 children with neurologic emergencies were seen during the study period with 33.6% occurring on weekends. The average duration of stay (DOS) was 7.6 (±5.7) days. There was no difference in DOS between children based on the day of admission (P = 0.241) or the hour of admission (P = 0.155). Eleven (7.5%) of study subjects died during the study period. There was no difference in outcome based on day ([weekends – 6.1% vs. weekday – 8.2%] [P = 0.896]) or hour of admission ([out-of-hour – 7.3% vs. working hours – 7.7%] [P = 0.958]). Weekend and out-of-hour duty does not affect the outcome of neurological emergencies in children.