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：已有研究显示，针对多种疾病而言，周末入院患者的死亡风险较工作日入院患者更高。本研究针对苏格兰国民保健服务（National Health Service, NHS）的急诊入院病例展开分析，旨在探讨周末急诊入院是否会增加患者死亡风险。
研究设计：队列研究。
研究场景：苏格兰国民保健服务急诊科室。
研究对象：1999年至2009年间共计5271327例急诊入院病例。本研究纳入所有来自苏格兰NHS苏格兰疾病登记系统01（Scottish Morbidity Records 01, SMR01）、经急诊收治且具备完整人口统计学资料的患者。
主要结局指标：英国总登记处（General Register Office, GRO）记录的死亡事件。
研究结果：与工作日急诊入院相比，周末急诊入院患者的死亡概率显著升高（未校正优势比（Odds Ratio, OR）=1.27，95%置信区间（Confidence Interval, CI）：1.26~1.28，p<0.0001；校正入院年份、性别、年龄、贫困五分位分组及合并症数量后，OR=1.42，95%CI：1.40~1.43，p<0.0001）。
研究结论：尽管过去11年间整体死亡率有所下降，但周末急诊入院仍与显著升高的额外死亡风险相关。未来应开展进一步研究以明确该现象背后的具体机制，从而制定针对性措施降低患者死亡风险。