Weekend admissions and increased risk for mortality: less urgent treatments only?

In an interesting study, Palmer et al reported increased risk of death in stroke patients hospitalized on weekends, with performance indicators significantly lower on weekends. Many studies investigated the “weekend effect” for acute diseases, and most confirmed increased risk of death. It seems unlikely that, in different countries and continents with diverse health service organizations, understaffing, less availability of procedures or services, or presence of inesperienced doctors may be the only possible causes. Temporal risk frames exist for acute cardiovascular diseases, with evident preferred times of onset. Patients arriving to the hospital on weekends for acute coronary syndrome, for example, are more likely to have a ST-elevation myocardial infarction. A combination of either increased clinical severity and less availability of hospital facilities might probably explain this worldwide phenomenon