Kawahigashi Teiko, Jo Taisuke, Komuro Tetsuya, De Waele Jan, De Bus Liesbet, Takaba Akihiro, Kuriyama Akira, Kobayashi Atsuko, Tanaka Chie, Hashi Hideki, Hashimoto Hideki, Nashiki Hiroshi, Shibata Mami, Kanamoto Masafumi, Inoue Masashi, Hashimoto Satoru, Katayama Shinshu, Fujiwara Shinsuke, Kameda Shinya, Shindo Shunsuke, Suzuki Taketo, Kawagishi Toshiomi, Kawano Yasumasa, Fujita Yoshihito, Kida Yoshiko, Hara Yuya, Yoshida Hideki, Fujitani Shigeki, Koyama Hiroshi
Department of Hematology, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa 247-8533, Japan.
Department of Critical Care Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
Ther Adv Infect Dis. 2025 May 28;12:20499361241292626. doi: 10.1177/20499361241292626. eCollection 2025 Jan-Dec.
Reduced or delayed access to medical resources on weekends could lead to worsening outcomes, in critically ill infected patients requiring intensive care unit (ICU) admission.
To investigate the "weekend effect," on critically ill infected patients in Japanese ICUs for the first time.
Multicenter retrospective cohort study.
We examined data from Japanese ICU patients participating in the DIANA study, a multicenter international observational cohort study. This prospective investigation enrolled critically ill patients with infections admitted to the ICU. The primary endpoint was successful discharge from the ICU within 28 days of admission. Outcome measures were evaluated through both univariate and covariate Cox regression analyses, providing hazard ratios (HRs) along with estimated 95% confidence intervals (CIs).
Out of the 276 patients enrolled in the DIANA study across 31 facilities, 208 patients (75.4%) meeting the inclusion criteria were included in the analysis. The weekday ICU admission group comprised 156 patients (75.0%), while the weekend ICU admission group comprised 52 patients (25.0%). In the multivariate Cox regression analysis, there were no statistically significant differences observed in the rates of ICU discharge alive within 28 days and 14 days (28 days, HR: 0.94, 95% CI: 0.63-1.40; 14 days, HR: 0.97, 95% CI: 0.64-1.48). Furthermore, the overall ICU mortality rates at 28 days and 14 days after ICU admission did not show statistical significance between patients admitted on weekends and those admitted on weekdays (ICU mortality, 28 days: 13.5% vs 11.5%, = 0.806; 14 days: 7.7% vs 10.9%, = 0.604).
The rates of ICU discharge alive within 28 days after ICU admission did not differ significantly between weekday and weekend admissions, both in the unadjusted and adjusted analyses. Moreover, further well-designed studies are warranted to thoroughly assess this effect.
对于需要入住重症监护病房（ICU）的重症感染患者，周末获得医疗资源的机会减少或延迟可能导致病情恶化。
首次调查日本ICU中重症感染患者的“周末效应”。
多中心回顾性队列研究。
我们检查了参与DIANA研究的日本ICU患者的数据，DIANA研究是一项多中心国际观察性队列研究。这项前瞻性调查纳入了入住ICU的重症感染患者。主要终点是入院后28天内从ICU成功出院。通过单因素和协变量Cox回归分析评估结局指标，提供风险比（HR）以及估计的95%置信区间（CI）。
在31个机构参与DIANA研究的276例患者中，208例符合纳入标准的患者（75.4%）纳入分析。工作日入住ICU组有156例患者（75.0%），而周末入住ICU组有52例患者（25.0%）。在多因素Cox回归分析中，28天和14天内ICU存活出院率无统计学显著差异（28天，HR：0.94，95%CI：0.63 - 1.40；14天，HR：0.97，95%CI：0.64 - 1.48）。此外，ICU入院后28天和14天的总体ICU死亡率在周末入院患者和工作日入院患者之间无统计学显著差异（ICU死亡率，28天：13.5%对11.5%，P = 0.806；14天：
