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2010 Annual Meeting Abstracts

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Is Mortality Following Non-Elective Admissions Worse on Weekends
*Rocco Ricciardi1, *Nancy N Baxter2, *Thomas E Read1, Patricia L Roberts1, David J Schoetz1, Peter W Marcello1
1Lahey Clinic, Burlington, MA;2University of Toronto, Toronto, ON, Canada

Objective: We hypothesized that mortality following non-elective admission to a hospital is higher when the day of admission is a weekend.
Design: Retrospective cohort analysis.
Setting: Patients admitted to hospitals in the Nationwide Inpatient Sample, a 20-percent sample of U.S. community hospitals.
Patients: We identified all patients with a non-elective admission from 1/1/2003 through 12/31/2007 in the Nationwide Inpatient Sample. Next, we abstracted vital status on discharge and calculated the Charlson comorbidity score for all inpatients. We then compared odds of inpatient mortality for non-elective admission on the weekend compared to weekday, after adjusting for diagnosis, age, sex, race, income level, payer, and comorbidity.
Main Outcome Measures: Mortality
Results: Data were available for 29,969,232 non-elective admissions during the five-year study period; 6,836,569 on weekends and 23,132,663 on weekdays. An inpatient mortality was reported in 185,856 (2.7%) patients admitted for non-elective indications on weekends and 540,639 (2.4%) on weekdays (p<0.0001). The odds of mortality was 1.17 {confidence interval (CI) 1.16-1.17] for non-elective weekend admission as compared to non-elective weekday admission. After adjusting for diagnosis, age, sex, race, income level, payer, and comorbidity, the overall odds of mortality was 10% higher (Odds ratio of 1.10 with CI of 1.09-1.11) for non-elective weekend admission as compared to non-elective weekday admission (p<0.0001).
Conclusions: These data demonstrate significantly worse outcomes following non-elective admission on the weekend as compared to the weekday. A comprehensive investigation of hospital staffing and service offerings is needed to help identify mutable factors that impact the delivery of non-elective services on weekends.


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