Data from: Weekend admission as an independent predictor of mortality: an analysis of Scottish hospital admissions

OBJECTIVES: Weekend admissions have been shown to be associated with an increased risk of mortality compared with weekday admissions for many diagnoses. We analysed emergency department admissions within the Scottish National Health Service to investigate whether mortality is increased in case of weekend emergency department admissions. DESIGN: A cohort study. SETTING: Scotland National Health Service (NHS) emergency departments. PARTICIPANTS: 5 271 327 emergency department admissions between 1999 and 2009. We included all patients admitted via emergency departments recorded in the Scottish Morbidity Records (SMR01) in NHS, Scotland for whom complete demographic data were available. PRIMARY OUTCOME MEASURES: Death as recorded by the General Register Office (GRO). RESULTS: There was a significantly increased probability of death associated with a weekend emergency admission compared with admission on a weekday (unadjusted OR 1.27, 95% CI 1.26 to 1.28, p<0.0001; adjusted for year of admission, gender, age, deprivation quintile and number of comorbidities OR 1.42, 95% CI 1.40 to 1.43, p<0.0001). CONCLUSIONS: Despite a general reduction in mortality over the last 11 years, there is still a significant excess mortality associated with weekend emergency admissions. Further research should be undertaken to identify the precise mechanisms underlying this effect so that measures can be put in place to reduce patient mortality.

研究目的：现有研究显示，针对多数诊断病症，周末急诊入院患者的死亡风险高于工作日入院患者。本研究针对苏格兰国家医疗服务体系（National Health Service, NHS）的急诊入院病例进行分析，以探讨周末急诊入院是否会提升患者死亡风险。
研究设计：队列研究。
研究场景：苏格兰国家医疗服务体系（NHS）急诊科室。
研究对象：1999年至2009年间共计5,271,327例急诊入院病例。本研究纳入苏格兰NHS下属的苏格兰疾病登记库01（Scottish Morbidity Records 01, SMR01）中记录的所有经急诊收治的患者，且需具备完整的人口统计学数据。
主要结局指标：由英国总登记署（General Register Office, GRO）记录的死亡事件。
研究结果：相较于工作日急诊入院，周末急诊入院患者的死亡风险显著升高（未校正优势比（Odds Ratio, OR）为1.27，95%置信区间（Confidence Interval, CI）为1.26至1.28，p<0.0001）；在校正入院年份、性别、年龄、贫困五分位组以及合并症数量后，优势比为1.42，95%置信区间为1.40至1.43，p<0.0001。
研究结论：尽管过去11年间整体死亡率呈下降趋势，但周末急诊入院仍与显著升高的超额死亡风险相关。未来应开展进一步研究以明确该现象的具体机制，从而制定针对性干预措施以降低患者死亡风险。