随着时间的推移，严重脓毒症患者周末效应与早期死亡率的关联。
Association of weekend effect with early mortality in severe sepsis patients over time.
机构信息
Section of Emergency Medicine and Critical Care, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Surgical ICU Translational Research (STAR) Center, Brigham and Women's Hospital, Boston, MA, USA; Department of Chest Medicine, Taipei City Hospital, Heping Fuyou Branch, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Nephrology, Taipei City Hospital, Heping Fuyou Branch, School of Medicine, National Yang-Ming University, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
出版信息
J Infect. 2017 Apr;74(4):345-351. doi: 10.1016/j.jinf.2016.12.009. Epub 2016 Dec 23.
BACKGROUND
The aim of this study is to investigate the "weekend effect" and early mortality of patients with severe sepsis.
METHODS
Using the Taiwanese National Healthcare Insurance Research Database, all patients who were hospitalized for the first time with an episode of severe sepsis between January 2000 and December 2011 were identified and the short-term mortality of patients admitted on weekdays was compared to those admitted on weekends. The primary endpoint was 7-day mortality. The secondary endpoints were 14 and 28-day mortality.
RESULTS
A total of 398,043 patients were identified to have had the diagnosis of severe sepsis. Compared with patients admitted on weekends, patients admitted on weekdays had a lower 7-day mortality rate (adjusted odds ratio [OR] 0.89, 95% confidential interval [CI] 0.87-0.91), 14-day mortality rate (adjusted OR 0.92, 95% CI 0.90-0.93), and 28-day mortality rate (adjusted OR 0.97, 95% CI 0.95-0.98). This "weekend effect" was maintained every year throughout the 11-year study period.
CONCLUSIONS
Patients with severe sepsis are more likely to die in the hospital if they were admitted on weekends than if they were admitted on weekdays.
背景
本研究旨在探讨严重脓毒症患者的“周末效应”和早期死亡率。
方法
利用台湾全民健康保险研究数据库，确定 2000 年 1 月至 2011 年 12 月期间首次因严重脓毒症住院的所有患者，并比较周末入院和工作日入院患者的短期死亡率。主要终点为 7 天死亡率。次要终点为 14 天和 28 天死亡率。
结果
共确定 398043 例患者患有严重脓毒症。与周末入院的患者相比，工作日入院的患者 7 天死亡率（调整后的优势比 [OR] 0.89，95%置信区间 [CI] 0.87-0.91）、14 天死亡率（调整后的 OR 0.92，95% CI 0.90-0.93）和 28 天死亡率（调整后的 OR 0.97，95% CI 0.95-0.98）均较低。这种“周末效应”在整个 11 年的研究期间每年都存在。
结论
与工作日入院相比，如果周末入院，严重脓毒症患者在医院内死亡的可能性更高。
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