Weekend hospital admissions linked to higher mortality rate

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The risk of mortality was 19% greater for weekend admissions vs weekday admissions.
The risk of mortality was 19% greater for weekend admissions vs weekday admissions.

Hospital inpatients admitted during weekends may have a higher mortality rate compared with inpatients admitted during the weekdays, according to a study published in the Journal of Hospital Medicine.

Lynn A Pauls, MD, BS, from the University of Pennsylvania, and colleagues performed a systematic review to examine the mortality rate for hospital inpatients admitted during the weekend (weekend death) compared with the mortality rate for those admitted during the work week (weekday death). The researchers performed a literature search of databases from January 1966 to April 2013 of studies that provided mortality data on weekends (including holidays) vs weekdays and included patients admitted during the weekend.

The primary outcome was all-cause weekend vs weekday mortality with subgroup analysis by personnel staffing levels, rates and times to procedures rates and delays, or illness severity. A total of 97 studies (51,114,109 patients) met inclusion criteria. When classifying the total number of patients across all articles, the investigators found that 76% were classified as weekday patients and 24% were weekend patients.

Among 12,279,385 weekend patients, 522,801 weekend deaths (4.26%) occurred, and among 39,834,724 weekday patients, 1,440,685 weekday deaths (3.62%) occurred.

Patients admitted on the weekends had a significantly higher overall mortality compared with those during the weekday. The risk of mortality was 19% greater for weekend admissions vs weekday admissions (relative risk [RR], 1.19). Patients admitted on the weekends consistently had higher mortality than those admitted during the week, regardless of the levels of weekend/weekday differences in staffing, procedure rates and delays, and illness severity.

“Our meta-analysis suggests that hospital inpatients admitted during the weekend have a significantly increased mortality compared with those admitted on weekday,” the authors stated. “While none of our subgroup analyses showed strong evidence on effect modification, the interpretation of these results is hampered by the relatively small number of studies.”

Reference

  1. Pauls LA, Johnson-Paben R, McGready J, et al. The weekend effect in hospitalized patients: a meta-analysis. J Hosp Med. 2017;12:760-766. doi: 10.12788/jhm.2815
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