ArticleBMJ quality & safety2018
Impact of out-of-hours admission on patient mortality: longitudinal analysis in a tertiary acute hospital.
Article in BMJ quality & safety, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Effect of off-hours admission on in-hospital mortality in sub-Saharan Africa: a systematic review and meta-analysis.Journal of health, population, and nutrition · 2026Pooled it
- Magnitude and modifiers of the weekend effect in hospital admissions: a systematic review and meta-analysis.BMJ open · 2019Pooled it
- Time to Splenic Embolisation in Trauma Patients Arriving at a Major Trauma Centre In-Hours or Out-of-Hours: A UK Multicentre Study.Cardiovascular and interventional radiology · 2026Article
- Timing of emergency department presentation and psychiatric consultation after self-harm or suicide attempts: a registry-based study in Japan.BMC psychiatry · 2026Observational
- Increased Mortality and Complication Rates in Weekend Admissions for Acute Decompensated Heart Failure: A Five-Year National Study.Journal of clinical medicine · 2026Article
- Weekend Effect and Predictors of Mortality for Patients Presenting to Emergency Department with COVID-19 Infection.Journal of personalized medicine · 2025Article
- Out-of-hours admissions in patients treated with immune checkpoint inhibitors and their primary management with steroids.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2024Article
- A Retrospective Analysis of Characteristics Favouring In-Hospital Resuscitation Plan Completion, Their Timing, and Associated Outcomes.Journal of clinical medicine · 2024Article
- Weekends admitted adult medical patients have higher in-hospital mortality in Ethiopia: An implication for quality improvement.PloS one · 2024Article
- A Machine Learning Approach to Support Urgent Stroke Triage Using Administrative Data and Social Determinants of Health at Hospital Presentation: Retrospective Study.Journal of medical Internet research · 2023Article
- Ambulance crew-initiated non-conveyance in the Helsinki EMS system-A retrospective cohort study.Acta anaesthesiologica Scandinavica · 2022Article
- Observational
- Holiday and weekend effects on mortality for acute myocardial infarction in Shanxi, China: a cross-sectional study.International journal of public health · 2020Article
- Prediction of in-hospital mortality in patients with post traumatic brain injury using National Trauma Registry and Machine Learning Approach.Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Article
- The weekend effect revisited: evidence from the Upper Austrian stroke registry.The European journal of health economics : HEPAC : health economics in prevention and care · 2019Article
- Protocol for a systematic review of time to antibiotics (TTA) in patients with fever and neutropenia during chemotherapy for cancer (FN) and interventions aiming to reduce TTA.Systematic reviews · 2019Article
- The enigma of the weekend effect.Journal of thoracic disease · 2018Article
- Telemedicine/Virtual ICU: Where Are We and Where Are We Going?Methodist DeBakey cardiovascular journalReview
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency hospital admission on weekends is associated with an increased risk of mortality. Previous studies have been limited to examining single years and assessing day-not time-of admission. We used an enhanced longitudinal data set to estimate the 'weekend effect' over time and the effect of night-time admission on all-cause mortality rates.
methodsWe examined 246 350 emergency spells from a large teaching hospital in England between April 2004 and March 2014. Outcomes included 7-day, 30-day and in-hospital mortality rates. We conducted probit regressions to estimate the impact on the absolute difference in the risk of mortality of two key predictors: (1) admission on weekends (19:00 Friday to 06:59 Monday); and (2) night-time admission (19:00 to 06:59). Logistic regressions were used to estimate ORs for relative mortality risk differences.
resultsCrude 30-day mortality rate decreased from 6.6% in 2004/2005 to 5.2% in 2013/2014. Adjusted mortality risk was elevated for all out-of-hours periods. The highest risk was associated with admission on weekend night-times: 30-day mortality increased by 0.6 percentage points (adjusted OR: 1.17, 95% CI 1.10 to 1.25), 7-day mortality by 0.5 percentage points (adjusted OR: 1.23, 95% CI 1.12 to 1.34) and in-hospital mortality by 0.5 percentage points (adjusted OR: 1.14, 95% CI 1.08 to 1.21) compared with admission on weekday daytimes. Weekend night-time admission was associated with increased mortality risk in 9 out of 10 years, but this was only statistically significant (p<0.05) in 5 out of 10 years.
conclusionsThere is an increased risk of mortality for patients admitted as emergencies both on weekends and during the night-time. These effects are additive, so that the greatest risk of mortality occurs in patients admitted during the night on weekends. This increased risk appears to be consistent over time, but the effects are small and are not statistically significant in individual hospitals in every year.
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