Key takeaways:

• 37,690 of 140,425 admissions occurred during weekends.
• Weekend admissions needed more aggressive interventions without more ancillary procedures.
• Better triage may allow earlier care escalation.

PHOENIX — Patients with status asthmaticus hospitalized during the weekend needed more care and experienced more mortality than those admitted during the rest of the week, according to an abstract presented at the CHEST Annual Meeting.

But this “weekend effect” was due to poorer health upon admission, not deficiencies in staffing or treatment, Anthony Lim, MD, an internal medicine physician at the Brooklyn Hospital Center, and colleagues wrote.

Data derived from Lim A, et al. The weekend effect of status asthmaticus: A case-control study. Presented at: CHEST Annual Meeting; Oct. 18-21, 2026; Phoenix.

Although the phrase “weekend effect” describes variabilities in staffing and delays in escalating care associated with greater mortality, the researchers said, national data about its relationship with status asthmaticus are limited.

The retrospective case-control study examined data from 140,425 hospitalizations for status asthmaticus between 2016 and 2023 recorded in the National Inpatient Sample, including 37,690 weekend admissions (mean age, 44.2 years).

Odds ratios for patients with weekend admissions compared with weekday admissions included 1.34 (95% CI, 1.12-1.61) for in-hospital mortality, 1.1 (95% CI, 1.03-1.18) for mechanical ventilation, 1.1 (95% CI, 1.03-1.18) for ICU utilization and 1.2 (95% CI, 1.02-1.41) for cardiac arrest.

The use of vasopressors, pneumothorax, tracheostomy, high-flow nasal canula, and continuous and bilevel positive airway pressure were not significantly different between the groups, the researchers said, nor were there any independent associations between weekend admission and length of stay or total hospital charges.

Based on these findings, the researchers said the patients in the weekend group were inherently sicker than those in the weekday group possibly because they do not go to the hospital until they are critically ill, as indicated by how they require interventions that are more aggressive and have greater mortality without needing other ancillary care.

The lack of an association between interventions that depend on intensivist care also indicates that the “weekend effect” is not caused by reductions in staffing, the researchers continued. If it were, they said, there would be differences in outcomes for all critical interventions beyond mortality and intubation.

Considering how sick patients are when they arrive on the weekend, the researchers suggested using arterial blood gas as well as APACHE II scores and other standardized severity assessments to better triage patients and escalate care earlier.