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Rahul Nanchal, MD, FCCP; Jeff Whittle, MD, MPH; Gagan Kumar, MD
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine (Drs Nanchal and Kumar) and Division of General Internal Medicine (Dr Whittle), Department of Medicine, Medical College of Wisconsin; and the Primary Care Division (Dr Whittle), Clement J. Zablocki VA Medical Center.

Correspondence to: Rahul Nanchal, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226; e-mail: rnanchal@mcw.edu


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(1):276. doi:10.1378/chest.12-2386
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To the Editor:

We thank Dr Manfredini and colleagues for their interest in our work.1 We agree that from the analysis of the administrative data, we are unable to determine a cause-and-effect relationship for the weekend effect. As mentioned in their letter, we did find that fewer people than expected with pulmonary embolism (PE) were admitted over the weekend than during the week. Weekend admissions for PE also had higher severity of illness as arbitrated by the need for mechanical ventilation, thrombolysis, and vasopressors. However, the weekend effect persisted when we controlled for all these factors, demographics, and random hospital effects, suggesting that perhaps other variables than those mentioned are responsible. We are also in agreement that carefully planned studies should be devoted to investigate the weekend effect in PE and other acute medical conditions.

References

Nanchal R, Kumar G, Taneja A, et al; from the Milwaukee Initiative in Critical Care Outcomes Research (MICCOR) Group of Investigators. Pulmonary embolism: the weekend effect. Chest. 2012;142(3):690-696. [CrossRef] [PubMed]
 

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References

Nanchal R, Kumar G, Taneja A, et al; from the Milwaukee Initiative in Critical Care Outcomes Research (MICCOR) Group of Investigators. Pulmonary embolism: the weekend effect. Chest. 2012;142(3):690-696. [CrossRef] [PubMed]
 
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