Neonatal Mortality in Weekend vs Weekday Births

Gould, Jeffrey B.; Cheng, Qin; Marks, Amy R.; Chávez, Gilberto

doi:10.1001/jama.289.22.2958

Cited by 120 publications

(123 citation statements)

References 13 publications

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“…18, 19 Bell and Redelmeier in 2001 13 and Cram et al in 2004 20 reported that the case fatality risk of AMI was higher in patients admitted on weekends than in those admitted on weekdays, as it was in this current study. However, in the earlier studies, the differences in the case fatality rate became statistically insignificant after adjusting for age, sex, and severity of AMI.…”

Section: Discussionsupporting

confidence: 59%

Comparison of Case Fatality Rates for Acute Myocardial Infarction in Weekday vs Weekend Admissions in South Korea

Hong

Kang

Lee

2010

Circ J

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Background: According to recent reports, reduced weekend staffing in hospitals may lead to a lower intensity of management of patients with acute conditions such as acute myocardial infarction (AMI). The present study evaluated differences in the case fatality rate of Korean patients admitted with AMI on weekdays vs those admitted on weekends. Methods and Results:The dataset was constructed from the Korea National Health Insurance Claims Database. The study population was 97,466 patients who were admitted to a hospital in Korea from 2003 to 2007 with AMI. Patients admitted on weekends had a higher 30-day fatality rate (20.1% vs 17.3%) than did those admitted on weekdays. Differences in the 30-day fatality rate were significant after adjusting for baseline characteristics and the severity of disease (odds ratio (OR), 1.21; 95% confidence interval (CI), 1.16-1.26). However, the 30-day fatality rate was insignificantly different after additional adjustment for medical or invasive management (OR 1.05; 95%CI 0.99-1.11).Conclusions: Differences in the case fatality rate of AMI patients admitted on weekdays and on weekends in Korea are caused by differences in the rate of performance of medical or invasive procedures. (Circ J 2010; 74: 496 - 502)

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Section: Discussionsupporting

confidence: 59%

Comparison of Case Fatality Rates for Acute Myocardial Infarction in Weekday vs Weekend Admissions in South Korea

Hong

Kang

Lee

2010

Circ J

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“…These results are also consistent with a recent study of neonatal mortality rates that used multivariate logistic regression to adjust for the severity of illness and the case mixture. 24 Although earlier neonatal studies noted higher weekend mortality rates, those analyses likely did not adjust adequately for potential confounders. 4,[6][7][8] Interestingly, the lack of a weekend effect in the current study and the recent neonatal study 24 differs from the results observed by Bell and Redelmeier, 1 who evaluated mortality rates among adult emergency admissions between 1988 and 1997 in Ontario, Canada.…”

Section: Discussionmentioning

confidence: 98%

“…24 Although earlier neonatal studies noted higher weekend mortality rates, those analyses likely did not adjust adequately for potential confounders. 4,[6][7][8] Interestingly, the lack of a weekend effect in the current study and the recent neonatal study 24 differs from the results observed by Bell and Redelmeier, 1 who evaluated mortality rates among adult emergency admissions between 1988 and 1997 in Ontario, Canada. The difference between these findings may represent differences between adult and pediatric patient populations or a distinction between the structure or processes of health care for adult versus pediatric patients.…”

Section: Discussionmentioning

confidence: 98%

Association Between Evening Admissions and Higher Mortality Rates in the Pediatric Intensive Care Unit

2004

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ABSTRACT. Background. Previous research investigating the relationship between the time of admission and mortality rates has yielded inconsistent results and has not been conducted in the pediatric intensive care unit (PICU) patient population.Objective. To determine whether an association between the time of admission (weekday versus weekend and daytime versus evening) and the risk of death exists among pediatric patients included in a cohort of children admitted to a national sample of PICUs.Design/Methods. We analyzed retrospectively a cohort of consecutive admissions to 15 PICUs included in the Pediatric Intensive Care Unit Evaluations database. The odds of death were analyzed by using mixed-effects, multivariate, logistic regression, with clustering at the hospital level. The primary independent variables were admission to the PICU on a weekend and admission to the PICU during evening hours. The severity of illness was adjusted by using the Pediatric Risk of Mortality III probability of death score.Patients. T o improve the quality of care, discrepancies in health care delivery and their effects on patient outcomes must be identified. Recent research has demonstrated that, among large patient cohorts, differences in time of admission are associated with differences in patient outcomes. Bell and Redelmeier 1 identified a significantly higher mortality rate among adult patients admitted on the weekend, compared with similar patients admitted on weekdays. Barnett et al, 2 in a study of Ͼ150 000 adult patients admitted to 38 intensive care units (ICUs), demonstrated both a higher risk-adjusted odds of in-hospital death and a longer ICU length of stay for patients admitted on the weekend, compared with patients admitted on weekdays. Similarly, neonatal mortality rates were shown to be slightly higher among infants born on weekends and during evening hours, compared with those born on weekdays and during daytime hours, respectively. [3][4][5][6][7][8] Whether an association exists between patient outcomes and time of admission in the pediatric patient population is unknown.To address this question, the Pediatric Intensive Care Unit Evaluations (PICUEs) database, representing a cohort of 34 993 pediatric ICU (PICU) patients from 15 institutions in the United States, was analyzed. 9 The objectives of this study were to compare the risk-adjusted mortality rates for weekend admissions versus weekday admissions and the risk-adjusted mortality rates for evening admissions versus daytime admissions. METHODS PatientsData for analysis were obtained from the most current available PICUEs database, Research Dataset 20 -02. 9 This database contains patient-level data from 34 993 admissions to 15 PICUs in the United States. Details of the site-selection procedures for the 15 study sites, general data-collection methods, and other analyses of this data set have been published. 9,10 Briefly, a minimum of 67 demographic, diagnostic physiologic, laboratory, and outcome data points were collected for all patients within 24 hours a...

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“…3,[6][7][8]11,[13][14][15][16]23,29,31,34 These databases could potentially include coding errors, usually originating from the hospital level, 9 although it seems likely that such errors would be consistent across the entire database rather than isolated to the weekend admissions. In addition, the database contains discharge records, which include discharges to other hospitals.…”

mentioning

confidence: 99%

Influence of weekend versus weekday hospital admission on mortality following subarachnoid hemorrhage

Crowley

Yeoh²,

Stukenborg

et al. 2009

JNS

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Object. Several studies have indicated that short-term mortality risk is higher among patients who are admitted on the weekends. This "weekend effect" has been observed among patients admitted with a variety of diagnoses, including myocardial infarction, pulmonary embolism, ruptured abdominal aortic aneurysm, and stroke. This study examines the relationship between short-term mortality risk and weekend admission among patients hospitalized following subarachnoid hemorrhage (SAH).Methods. This retrospective cohort study examines mortality outcomes among patients included in the Nationwide Inpatient Sample (NIS) for 2004. Patients included in the cohort were identified using the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) code for SAH. Multivariable logistic regression analyses and Cox proportional hazard regression analyses are used to measure the association of weekend admission on mortality for patients with SAH, adjusted for differences in patient characteristics that also contribute to mortality risk.Results. Weekend admissions occurred among 27.5% of the 5667 patients with SAH in the NIS database. Weekend admission was not a statistically significant independent predictor of death in the SAH study population at 7 days (OR 1.07, 95% CI 0.91-1.25), 14 days (OR 1.01, 95% CI 0.87-1.17), or 30 days (OR 1.03, 95% CI 0.89-1.19).Conclusions. Weekend admission is not associated with significantly increased short-term mortality risk among patients hospitalized with SAH. (DOI: 10.3171/2008.11.JNS081038) Key WoRDs • intracranial aneurysm • mortality • subarachnoid hemorrhage • weekend effectAbbreviations used in this paper: HR = hazard ratio; ICU = intensive care unit; SAH = subarachnoid hemorrhage.

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Neonatal Mortality in Weekend vs Weekday Births

Cited by 120 publications

References 13 publications

Comparison of Case Fatality Rates for Acute Myocardial Infarction in Weekday vs Weekend Admissions in South Korea

Comparison of Case Fatality Rates for Acute Myocardial Infarction in Weekday vs Weekend Admissions in South Korea

Association Between Evening Admissions and Higher Mortality Rates in the Pediatric Intensive Care Unit

Influence of weekend versus weekday hospital admission on mortality following subarachnoid hemorrhage

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