In-patient hospital mortality patterns by day of the week: an analysis of admissions to a regional renal unit
In-patient hospital mortality patterns by day of the week: an analysis of admissions to a regional renal unit
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DOI：
10.1177/0036933015619293
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发表时间：
2016-11-01
影响因子：
2.7
通讯作者：
Thomson, Peter C.
中科院分区：
文献类型：
--
作者：
Haddock, Rosemary;Deighan, Christopher;Thomson, Peter C.
背景和目的：据报道，与工作日相比，周末入院的患者死亡率较高。我们的目的是评估住院患者的死亡率模式的一周中的一天，在三级renal unit.Method和结果：死亡率相关的入院日和死亡日进行了分析，在格拉斯哥西部医院肾单位超过两年的时间。还在两个随机的四周期间评估了典型的案件量。作为入院比例，周末的30天死亡率为46/540（8.5%），而工作日为107/2013（5.3%）（RR 1.60，p=0.005）。30天死亡率为46/208=0.22例死亡/入院周末日，而107/523=0.20例死亡/入院工作日（发病率比=1.08，p=0.67）。与工作日相比，周末的死亡风险没有显著增加（RR 1.23，p=0.23）。周末入院的病人中，来自其他医院的比例较高。急性肾损伤和血液透析患者形成了较高的百分比accounts.Conclusion：入院日死亡率表示为死亡率/天之间没有不同的周末/工作日入院。入院日死亡率表示为总入院人数的比例显着较高，在周末。这表明，入院病例组合/工作量在周末有所不同，入院的“健康”患者较少。住院患者死亡率模式很复杂，任何结论都应考虑到病例组合和工作量。
Background and aims: Higher mortality rates have been reported for patients admitted at a weekend compared to a weekday. Our aim was to assess in-patient mortality patterns by day of the week, in a tertiary renal unit.Method and results: Mortality related to day of admission and day of death was analysed over a two-year period at Glasgow Western Infirmary renal unit. Typical caseload was also assessed over two random four-week periods. As a proportion of admissions, 30-day mortality was 46/540 (8.5%) on a weekend day compared with a weekday 107/2013 (5.3%) (RR1.60, p=0.005). Thirty-day mortality rate was 46/208=0.22 deaths/weekend day of admission compared with 107/523=0.20 deaths/weekday of admission (incident rate ratio=1.08, p=0.67). There was no significant increased risk of death on a weekend day compared to a weekday (RR1.23, p=0.23). A higher proportion of weekend admissions were from other hospitals. Acute kidney injury and haemodialysis patients formed a higher percentage of admissions.Conclusion: Admission day mortality expressed as a death rate/day does not differ between weekend/weekday admissions. Admission day mortality expressed as a proportion of total admissions was significantly higher at weekends. This suggests admission case-mix/workload differs at weekends with fewer 'well' patients admitted. In-patient mortality patterns are complex and any conclusions made should take into account case mix and workload.