Analysis of the Mortality of Patients Admitted to Internal Medicine Wards Over the Weekend
Analysis of the Mortality of Patients Admitted to Internal Medicine Wards Over the Weekend
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DOI：
10.1177/1062860610366031
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发表时间：
2010-07-01
影响因子：
1.4
通讯作者：
Zapatero, Antonio
中科院分区：
文献类型：
--
作者：
Marco, Javier;Barba, Raquel;Zapatero, Antonio
周末收治的病人的管理可能会受到影响，因为医院的工作人员水平往往较低。本研究旨在评估周末入院对住院死亡率的独立影响（如果有）。作者分析了429880名14岁以上的成年人的临床数据，这些成年人在前往医院急诊室后被送入西班牙内科病房。检查了总体死亡率和早期死亡率（发生在最初48小时内），考虑了患者是在周末还是工作日入院，以及其他参数。在接受内科服务的患者中，周末入院与住院死亡率显著高于工作日入院相关（比值比[OR] = 1.1; 95%置信区间[CI] = 1.14-1.08）。校正年龄、性别和共存疾病后，死亡率的差异仍然存在（OR = 1.071; 95%CI = 1.046-1.097）。对入院后2天内死亡的分析显示，周末和工作日入院的死亡率相对差异较大（OR = 1.28; 95%CI = 1.22-1.33）。对于通过急诊室急诊护理就诊而接受内科服务的患者，周末入院的死亡率高于一周内入院的死亡率。
The management of patients admitted during weekends may be compromised because the level of staffing in the hospital is often lower then. This study was conducted to assess what independent influence, if any, weekend admission might have on inhospital mortality. The authors analyzed the clinical data of 429 880 adults > 14 years of age who were admitted to internal medicine wards in Spain after having presented to the hospitals' emergency departments. Overall mortality and early mortality (occurring in the first 48 hours) were examined, taking into account whether a patient was admitted on a weekend or a weekday, in addition to other parameters. Weekend admissions were associated with a significantly higher inhospital mortality than weekday admissions among patients admitted to an internal medicine service (odds ratio [OR] = 1.1; 95% confidence interval [CI] = 1.14-1.08). Differences in mortality persisted after adjustment for age, sex, and coexisting disorders (OR = 1.071; 95% CI = 1.046-1.097). Analyses of deaths within 2 days after admission showed larger relative differences in mortality between weekend and weekday admissions (OR = 1.28; 95% CI = 1.22-1.33). For patients admitted to an internal medicine service via an acute care visit to the emergency room, admission on weekends is associated with higher mortality than admission during the week.