ArticleBMJ open2018
Role of organisational factors on the 'weekend effect' in critically ill patients in Brazil: a retrospective cohort analysis.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Weekend admissions and outcomes in patients with pneumonia: a systematic review and meta-analysis.Frontiers in public health · 2023Pooled it
- Patient and medical choice across public and private health providers: the case of birth timing manipulation in Brazil.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Benchmarking and efficiency assessment in intensive care units: a systematic review protocol.Critical care science · 2026Article
- ICU admission delays: Impact on length of stay and long-term outcomes.Biomolecules & biomedicine · 2025Article
- Effect of Admission Day and Time on Patient Outcome: An Observational Study in Intensive Care Units of a Tertiary Care Hospital in India.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Day and Time of Admission to ICU Affects Patient Outcome: An Illogical Belief?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Update on the Epimed Monitor Adult ICU Database: 15 years of its use in national registries, quality improvement initiatives and clinical research.Critical care science · 2024Review
- A decade of the ORCHESTRA study: organizational characteristics, patient outcomes, performance and efficiency in critical care.Critical care science · 2024Article
- Weekends admitted adult medical patients have higher in-hospital mortality in Ethiopia: An implication for quality improvement.PloS one · 2024Article
- Association between ICU admission during off-hours and in-hospital mortality: a multicenter registry in Japan.Journal of intensive care · 2022Article
- A scoping review of registry captured indicators for evaluating quality of critical care in ICU.Journal of intensive care · 2021Article
- Association between off-hour admission of critically ill children to intensive care units and mortality in a Japanese registry.Scientific reports · 2021Article
- The weekend effect for stroke patients admitted to intensive care: A retrospective cohort analysis.PloS one · 2020Article
- Article
- Evaluation of bed vacancy and occupancy times as governance parameters in patients admitted to a public intensive care unit.Revista Brasileira de terapia intensivaObservational
Corrections and comments
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHigher mortality for patients admitted to intensive care units (ICUs) during the weekends has been occasionally reported with conflicting results that could be related to organisational factors. We investigated the effects of ICU organisational and staffing patterns on the potential association between weekend admission and outcomes in critically ill patients.
methodsWe included 59 614 patients admitted to 78 ICUs participating during 2013. We defined 'weekend admission' as any ICU admission from Friday 19:00 until Monday 07:00. We assessed the association between weekend admission with hospital mortality using a mixed logistic regression model controlling for both patient-level (illness severity, age, comorbidities, performance status and admission type) and ICU-level (decrease in nurse/bed ratio on weekend, full-time intensivist coverage, use of checklists on weekends and number of institutional protocols) confounders. We performed secondary analyses in the subgroup of scheduled surgical admissions.
resultsA total of 41 894 patients (70.3%) were admitted on weekdays and 17 720 patients (29.7%) on weekends. In univariable analysis, weekend admitted patients had higher ICU (10.9% vs 9.0%, P<0.001) and hospital (16.5% vs 13.5%, P<0.001) mortality. After adjusting for confounders, weekend admission was not associated with higher hospital mortality (OR 1.05, 95% CI 0.99 to 1.12, P=0.095). However, a 'weekend effect' was still observed in scheduled surgical admissions, as well as in ICUs not using checklists during the weekends. For unscheduled admissions, no 'weekend effect' was observed regardless of ICU's characteristics. For scheduled surgical admissions, a 'weekend effect' was present only in ICUs with a low number of implemented protocols and those with a reduction in the nurse/bed ratio and not applying checklists during weekends.
conclusionsICU organisational factors, such as decreased nurse-to-patient ratio, absence of checklists and fewer standardised protocols, may explain, in part, increases in mortality in patients admitted to the ICU mortality on weekends.
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