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Weekend versus weekday admission and short-term mortality: A meta-analysis of 88
cohort studies including 56,934,649 participants
#MMPMID28445269
Hoshijima H
; Takeuchi R
; Mihara T
; Kuratani N
; Mizuta K
; Wajima Z
; Masaki E
; Shiga T
Medicine (Baltimore)
2017[Apr]; 96
(17
): e6685
PMID28445269
show ga
It is widely accepted that higher mortality related to weekend admissions
basically exists; however, there has been no systematic exploration of whether
weekend admissions are associated with higher risk of death in patients on the
basis of certain diagnoses, geographic regions, and study subtypes.A
meta-analysis was performed according to the reporting guidelines of the
Meta-analysis of Observational Studies in Epidemiology (MOOSE Compliant).
Literature search was conducted using electronic databases. Primary outcome was
short-term (?30-day) mortality. Patients were divided into 7 regions (North
America, South America, Europe, Asia, Oceania, Africa, and Antarctica) for
subgroup analyses and into 7 categories evaluating 24 major diagnoses. Pooled
odds ratio (OR) with 95% confidence interval (CI) was calculated with DerSimonian
and Laird random-effects models.Eighty-eight studies including 56,934,649
participants met our inclusion criteria. Overall pooled adjusted and crude OR of
weekend to weekday admission for short-term mortality was 1.12 (95% CI,
1.07-1.18; I?=?97%) and 1.16 (95% CI, 1.14-1.19; I?=?97%), respectively. In
subgroup analyses, higher risk of death on the weekend was significantly
identified in patients living in all five continents (North America, South
America, Europe, Asia, and Oceania). However, significant weekend effect was
identified only in 15 of 24 diagnostic groups. Patients admitted on the weekend
were more likely to die in an emergency situation (crude OR?=?1.17, 95% CI,
1.12-1.22).Although weekend admissions were associated with higher risk of death
compared with weekday admissions on all five continents, the effect was limited
to certain diagnostic groups and admission subtypes. Weekend effect remains
highly heterogeneous and limited, suggesting that further well-conducted cohort
studies might be informative.
|*Mortality
[MESH]
|*Patient Admission/statistics & numerical data
[MESH]
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