ArticleBMJ quality & safety2019
Sicker patients account for the weekend mortality effect among adult emergency admissions to a large hospital trust.
Article in BMJ quality & safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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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
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Applications of the Early Warning Score as an outcome measure: a systematic review of methodologies.BMJ health & care informatics · 2026Pooled it
- Weekend effect in emergency hospitalizations of older adults in Hong Kong.Scientific reports · 2026Article
- Impact of weekend admission on in-hospital mortality in chronic kidney disease: a nationwide analysis of 184 299 hospitalisations in Poland (2017-2021).BMC nephrology · 2026Article
- Weekend Effect and Predictors of Mortality for Patients Presenting to Emergency Department with COVID-19 Infection.Journal of personalized medicine · 2025Article
- The Weekend Effect on In-Hospital Mortality-First 13-Year Retrospective Observational Study in Slovakia.Healthcare (Basel, Switzerland) · 2025Article
- Effect of Weekend Admission on Hip Fracture Mortality.Ochsner journal · 2025Article
- Does the weekend effect exist for acute type A aortic dissection?-a retrospective case-control study.Journal of thoracic disease · 2023Article
- Daylight saving time affects European mortality patterns.Nature communications · 2022Article
- Article
- Impact of varying wave periods of COVID-19 on in-hospital mortality and length of stay for admission through emergency department: A territory-wide observational cohort study.Influenza and other respiratory viruses · 2022Observational
- Weekend Mortality in an Italian Hospital: Immediate versus Delayed Bedside Critical Care Treatment.International journal of environmental research and public health · 2022Article
- Observational
- Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the 7-day services national health policy.BMJ quality & safety · 2021Article
- Likelihood of admission to hospital from the emergency department is not universally associated with hospital bed occupancy at the time of admission.The International journal of health planning and management · 2021Article
- Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study.PloS one · 2021Article
- Observational
- Holiday and weekend effects on mortality for acute myocardial infarction in Shanxi, China: a cross-sectional study.International journal of public health · 2020Article
- Weekend effect on mortality by medical specialty in six secondary hospitals in the Helsinki metropolitan area over a 14-year period.BMC health services research · 2020Article
- Severity of illness and the weekend mortality effect: a retrospective cohort study.BMC health services research · 2020Article
- Exploring the characteristics, acuity and management of adult ED patients at night-time.Emergency medicine journal : EMJ · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectiveTo determine whether the higher weekend admission mortality risk is attributable to increased severity of illness.
designRetrospective analysis of 4 years weekend and weekday adult emergency admissions to a university teaching hospital in England. OUTCOME MEASURES: 30-day postadmission weekend:weekday mortality ratios adjusted for severity of illness (baseline National Early Warning Score (NEWS)), routes of admission to hospital, transfer to the intensive care unit (ICU) and demographics.
resultsDespite similar emergency department daily attendance rates, fewer patients were admitted on weekends (mean admission rate 91/day vs 120/day) because of fewer general practitioner referrals. Weekend admissions were sicker than weekday (mean NEWS 1.8 vs 1.7, p=0.008), more likely to undergo transfer to ICU within 24 hours (4.2% vs 3.0%), spent longer in hospital (median 3 days vs 2 days) and less likely to experience same-day discharge (17.2% vs 21.9%) (all p values <0.001).The crude 30-day postadmission mortality ratio for weekend admission (OR=1.13; 95% CI 1.08 to 1.19) was attenuated using standard adjustment (OR=1.11; 95% CI 1.05 to 1.17). In patients for whom NEWS values were available (90%), the crude OR (1.07; 95% CI 1.01 to 1.13) was not affected with standard adjustment. Adjustment using NEWS alone nullified the weekend effect (OR=1.02; 0.96-1.08).NEWS completion rates were higher on weekends (91.7%) than weekdays (89.5%). Missing NEWS was associated with direct transfer to intensive care bypassing electronic data capture. Missing NEWS in non-ICU weekend patients was associated with a higher mortality and fewer same-day discharges than weekdays.
conclusionsPatients admitted to hospital on weekends are sicker than those admitted on weekdays. The cause of the weekend effect may lie in community services.
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