Mortality among adult patients admitted to the hospital on weekends

Barba, Raquel; Losa, Juan Emilio; Velasco, María; Guijarro, Carlos; Casasola, G. García de; Zapatero, Antonio

doi:10.1016/j.ejim.2006.01.003

Cited by 115 publications

(76 citation statements)

References 10 publications

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“…A University of Maryland study suggested similar increases in mortality for all patients admitted through emergency rooms on weekends compared with patients admitted on weekdays, with logistic regression suggesting that this increase in mortality correlated with longer delays between presentation to the emergency room and admission to an inpatient unit, where presumably more aggressive treatment might be administered [25] . Similar observations have been made for 48 h mortality after admission to the hospital on weekends in comparison to patients admitted on weekdays in Spain [26] . The weekend effect may not be universal, however.…”

Section: Introductionsupporting

confidence: 70%

Preventing physician quality of life from impinging on patient quality of care: Weakening the weekend effect

Basson¹

2007

WJG

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Imprecise or delayed care can reflect many factors, including straightforward difficulties in physician judgment and false negative tests. However, the movement toward decreasing physician work hours also leads to delays in care caused by inadequate staffing or inadequate communication between staffing, which must be addressed if quality of care is to remain high. The demonstration of delays in the management of anastomotic leaks over weekends or in association with false positive radiologic studies exemplifies this challenge.

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Section: Introductionsupporting

confidence: 70%

Preventing physician quality of life from impinging on patient quality of care: Weakening the weekend effect

Basson¹

2007

WJG

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“…This effect is also true when considering only deaths within the first two days of admission. [1][2][3] In large studies, mortality has also been reported to be increased for weekend admissions with specific medical conditions such as myocardial infarction, 4 heart failure, 5 upper gastrointestinal bleeding, 6,7 pulmonary embolism, 8 stroke 9 and intracerebral haemorrhage, 10 although a single-centre UK study of six specific medical conditions failed to demonstrate this effect. 11 Worse outcomes have been reported for patients admitted outside normal working hours with myocardial infarction 12 and in 'night-time' (6 pm-8 am) admissions to some intensive care units.…”

Section: Introductionmentioning

confidence: 97%

Mortality in out-of-hours emergency medical admissions – more than just a weekend effect

Maggs¹,

Mallet²

2010

JRCPE

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Mortality among emergency medical admissions to hospital is higher for admissions at the weekend than on weekdays; this also holds true for certain specific conditions. However, it is unknown whether that effect is limited to weekends. This study calculated mortality in emergency medical admissions for each day of the week, and compared mortality at weekends with weekdays, at nights with days, and in all out-of-hours periods with in-hours in a UK district general hospital. Total mortality was increased for admissions on Mondays, at night, and in all out-of-hours periods; late in-hospital mortality (after seven days) remained increased when the initial admission occurred on Mondays, at night or out of hours. It is likely that illness severity as well as resource and organisational factors are involved.

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“…The acute exacerbation phase entails a substantial rate of hospital mortality [6]. The recognition of risk factors for mortality among patients hospitalised for COPD can be of crucial importance for curtailing cost and reducing mortality.Several studies [7][8][9][10][11][12] concluded that weekend hospitalisation is associated with worse health outcomes. These studies are supported by the work of others [13,14], which find a positive correlation across hospitals between annual average staff-to-patients ratios and quality of care.…”

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confidence: 99%

The impact of weekends on outcome for acute exacerbations of COPD

Barba

Zapatero²,

Losa³

et al. 2011

European Respiratory Journal

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Differences in hospital staffing may influence outcomes for patients with acute conditions, including acute exacerbations of chronic obstructive pulmonary disease (COPD), depending on which day of the week the patients are admitted. This study was conducted to determine whether weekend admission increases the risk of dying in hospital.We analysed the clinical data of 289,077 adults with acute exacerbations of COPD admitted to the hospital at any public centre in Spain, during 2006 and 2007. We analysed the following factors for their association with death rate: day of admission, demographics, medical history and comorbidity.During the study period, there were 35,544 (12.4%) deaths during admission in COPD patients. Weekend admissions were associated with a significantly higher in-hospital mortality (12.9%) than weekday admissions (12.1%) among COPD patients (OR 1.07 (95% CI 1.04-1.10)). The differences in mortality persisted after adjustment for age, sex and coexisting disorders (OR 1.05 (95% CI 1.02-1.08)). Analyses of deaths within 2 days after admission showed larger relative differences in mortality between the weekend and weekday admissions (OR 1.17 (95% CI 1.11-1.23)).We conclude that patients with acute exacerbations of COPD are more likely to die in the hospital if they are admitted on a weekend compared with a weekday.KEYWORDS: Chronic obstructive pulmonary disease, mortality, weekend effect A cute exacerbations of chronic obstructive pulmonary disease (COPD) are among the leading causes of morbidity and mortality in industrialised countries [1,2]. ,10% of all hospitalisations are either directly or indirectly attributable to COPD [3], and internal medicine [4] and respiratory wards care for many patients with this disease. Acute exacerbations of COPD requiring hospital treatment are a severe strain on health services and are responsible for at least two-thirds of the total cost of treating respiratory diseases in both Europe and the USA [5]. The acute exacerbation phase entails a substantial rate of hospital mortality [6]. The recognition of risk factors for mortality among patients hospitalised for COPD can be of crucial importance for curtailing cost and reducing mortality.Several studies [7][8][9][10][11][12] concluded that weekend hospitalisation is associated with worse health outcomes. These studies are supported by the work of others [13,14], which find a positive correlation across hospitals between annual average staff-to-patients ratios and quality of care. While the burden of disease and demand on health services is similar from one day to the next, at the weekend, there are staff shortages and reduced availability of services. Unfortunately, this might not be compensated for by increased care on subsequent days.The weekend effect on COPD has been specifically studied in a recent Australian study [15] by a retrospective analysis of administrative data from public hospitals, analysing the 30-day inhospital mortality in 30,000 patients; no significant weekend effect was detected. Ho...

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Mortality among adult patients admitted to the hospital on weekends

Cited by 115 publications

References 10 publications

Preventing physician quality of life from impinging on patient quality of care: Weakening the weekend effect

Preventing physician quality of life from impinging on patient quality of care: Weakening the weekend effect

Mortality in out-of-hours emergency medical admissions – more than just a weekend effect

The impact of weekends on outcome for acute exacerbations of COPD

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