An Ruopeng
Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana, Champaign.
Ann Epidemiol. 2017 Dec;27(12):790-795. doi: 10.1016/j.annepidem.2017.10.001. Epub 2017 Oct 19.
Over the past decade, the media, politicians, practitioners, and researchers paid increasing attention to the risks involved in hospital admission at weekends. This study examined the impact of weekend admission on in-hospital mortality among U.S. adults and by sex, age, race/ethnicity, and disease category and tracked changes from 2003 to 2013.
Over 50 million hospital discharge data came from 2003 to 2013 National Inpatient Sample. Cox regressions were performed to estimate the hazard ratios of in-hospital mortality associated with weekend admission, adjusting for individual and hospital characteristics and National Inpatient Sample sampling design.
Compared to weekday admissions, weekend admissions were associated with increased in-hospital morality risk by 5% among all inpatients. Young adults (2.7%) had lower incremental mortality risk than middle aged (5.3%) and older adults (5.2%). Among the 10 leading causes of death, patients hospitalized at weekends due to malignant neoplasms (12.1%), diabetes mellitus (11.7%), and heart diseases (8.2%) had the highest incremental mortality risk. The estimated weekend effects tended to be more prominent among inpatients with higher assessed mortality risk. Incremental morality attributable to weekend hospitalization decreased from 6.9% in 2003 to 2.5% in 2013.
Weekend admissions were associated higher in-hospital mortality, but the impact declined during 2003-2013.
在过去十年中，媒体、政治家、从业者和研究人员越来越关注周末住院所涉及的风险。本研究调查了周末住院对美国成年人住院死亡率的影响，并按性别、年龄、种族/民族和疾病类别进行分析，同时追踪了2003年至2013年的变化情况。
超过5000万份医院出院数据来自2003年至2013年的全国住院患者样本。进行Cox回归分析，以估计与周末住院相关的住院死亡率的风险比，并对个体和医院特征以及全国住院患者样本抽样设计进行调整。
与工作日住院相比，所有住院患者中，周末住院的住院死亡风险增加了5%。年轻人（2.7%）的额外死亡风险低于中年（5.3%）和老年人（5.2%）。在十大主要死因中，因恶性肿瘤（12.1%）、糖尿病（11.7%）和心脏病（8.2%）在周末住院的患者额外死亡风险最高。估计周末效应在评估死亡风险较高的住院患者中往往更为突出。周末住院导致的额外死亡率从2003年的6.9%降至2013年的2.5%。
周末住院与较高的住院死亡率相关，但在2003 - 2013年期间这种影响有所下降。
