ArticleBMC medicine2017
The association between the day of the week of milestones in the care pathway of patients with hip fracture and 30-day mortality: findings from a prospective national registry - The National Hip Fracture Database of England and Wales.
Article in BMC medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Surgical interventions for treating intracapsular hip fractures in older adults: a network meta-analysis.The Cochrane database of systematic reviews · 2022Pooled it
- Arthroplasties for hip fracture in adults.The Cochrane database of systematic reviews · 2022Pooled it
- Surgical interventions for treating extracapsular hip fractures in older adults: a network meta-analysis.The Cochrane database of systematic reviews · 2022Pooled it
- Internal fixation implants for intracapsular hip fractures in older adults.The Cochrane database of systematic reviews · 2021Pooled it
- The weekend effect: does hospital mortality differ by day of the week? A systematic review and meta-analysis.BMC health services research · 2018Pooled it
- Article
- ChatGPT in Orthopedic Trauma: Consistency, Accuracy, and Agreement With Textbook and Expert Opinion.Cureus · 2026Article
- Waiting time and 30-day mortality association in elderly patients having hip fracture surgery.BMC surgery · 2025Article
- Effect of Weekend Admission on Hip Fracture Mortality.Ochsner journal · 2025Article
- Limited impact of weekend admissions on hip fracture outcomes in elderly patients: A study from a Japanese nationwide medical claims database.Geriatrics & gerontology international · 2025Article
- Management of Femoral Periprosthetic Fractures: An Institutional Experience at a District General Hospital.Cureus · 2024Article
- Article
- Impact of surgical timing and type of operative procedure on outcomes in periprosthetic hip fractures: an observational study at an NHS trust centre in the UK.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Observational
- Early mobilisation following fragility hip fracture surgery: current trends and association with discharge outcomes in a local tertiary hospital.Singapore medical journal · 2023Observational
- [Financial and health impact of two models of providing prostheses in a public health systemImpacto econômico e sanitário de dois modelos de fornecimento de próteses em um sistema público de saúde].Revista panamericana de salud publica = Pan American journal of public health · 2023Article
- [Development of the inpatient quality of care of surgically treated patients with a proximal femoral fracture in North Rhine-Westphalia : Analysis of 61,249 treatment courses based on data from external inpatient quality assurance].Unfallchirurgie (Heidelberg, Germany) · 2022Article
- Differences of hemiarthroplasty and total hip replacement in orthogeriatric treated elderly patients: a retrospective analysis of the Registry for Geriatric Trauma DGUEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Impact of subtrochanteric fractures in the geriatric population: better pre-fracture condition but poorer outcome than pertrochanteric fractures: evidence from the Spanish Hip Fracture Registry.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2022Observational
- Machine learning outperforms clinical experts in classification of hip fractures.Scientific reports · 2022Article
- Hip fracture patients admitted to hospital on weekends are not at increased risk of 30-day mortality as compared with weekdays.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundRecent publications indicate increased mortality in patients admitted to hospital at the weekend, but these findings may be subject to inadequate adjustment for case-mix and the complexities of resource provision. Hip fractures generally occur in a frail comorbid population with a consistent diagnosis precipitating admission as an emergency. We therefore aimed to examine the association between the day of the week of milestones in the care pathway and 30-day mortality in this population.
methodsUsing data from a prospective national database of hip fractures, we investigated the association between day of the week of admission, surgery, inpatient stay, and discharge (care pathway milestones) and 30-day mortality using generalised linear models. Data was collected between January 1, 2011, and December 31, 2014, on 241,446 patients. An incremental case-mix adjustment strategy was performed using patient characteristics, non-surgical interventions, surgical interventions and discharge characteristics.
resultsThe day of admission was not associated with 30-day mortality. Sunday surgery (OR, 1.094; 95% CI, 1.043-1.148; P < 0.0001) and a delay to surgery of more than 24-hours (OR, 1.094; 95% CI, 1.059, 1.130; P < 0.0001) were both associated with a 9.4% increase in 30-day mortality. Discharge from the hospital on a Sunday (OR, 1.515; 95% CI, 1.224, 1.844; P < 0.0001) or out-of-hours discharge (OR, 1.174; 95% CI, 1.081, 1.276; P < 0.0001) were associated with a 51.5% and 17.4% increase in 30-day mortality, respectively. Mortality during the inpatient stay was 5.6% lower (IRR, 0.944; 95% CI, 0.909, 0.980; P = 0.003) at the weekend compared to weekdays.
conclusionsThere is limited evidence of a generalised weekend effect in patients admitted to hospital for hip fracture. Optimising resource utilisation is an essential element of planning and delivering healthcare services. Interventions that lead to surgery within 24-hours of admission are justified. Factors such as Sunday operations, discharge and out-of-hours discharge require further investigation.
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