Aylin Paul, Yunus A, Bottle A, Majeed A, Bell D
Dr Foster Unit at Imperial College, Department of Primary Care and Social Medicine, Imperial College London, London SW7 2AZ, UK.
Qual Saf Health Care. 2010 Jun;19(3):213-7. doi: 10.1136/qshc.2008.028639. Epub 2010 Jan 28.
Several studies have identified higher mortality for patients admitted as emergencies at the weekend compared with emergency admissions during the week, but most have focused on specific conditions or have had a limited sample size.
Using routinely collected hospital administrative data, we examined in-hospital deaths for all emergency inpatient admissions to all public acute hospitals in England for 2005/2006. Odds of death were calculated for admissions at the weekend compared to admissions during the week, adjusted for age, sex, socioeconomic deprivation, comorbidity and diagnosis.
Of a total of 4,317,866 emergency admissions, we found 215,054 in-hospital deaths with an overall crude mortality rate of 5.0% (5.2% for all weekend admissions and 4.9% for all weekday admissions). The overall adjusted odds of death for all emergency admissions was 10% higher (OR 1.10, 95% CI 1.08 to 1.11) in those patients admitted at the weekend compared with patients admitted during a weekday (p<0.001).
This is the largest study published on weekend mortality and highlights an area of concern in relation to the delivery of acute services.
多项研究表明，与工作日的急诊入院患者相比，周末急诊入院患者的死亡率更高，但大多数研究聚焦于特定病症或样本量有限。
我们利用常规收集的医院管理数据，对2005/2006年英格兰所有公立急症医院的所有急诊住院患者的院内死亡情况进行了研究。计算周末入院患者与工作日入院患者相比的死亡几率，并根据年龄、性别、社会经济剥夺程度、合并症和诊断进行调整。
在总共4317866例急诊入院患者中，我们发现215054例院内死亡，总体粗死亡率为5.0%（所有周末入院患者为5.2%，所有工作日入院患者为4.9%）。与工作日入院患者相比，周末入院患者的所有急诊入院总体调整后死亡几率高出10%（比值比1.10，95%置信区间1.08至1.11）（p<0.001）。
这是关于周末死亡率发表的最大规模研究，凸显了急性服务提供方面令人担忧的一个领域。
