+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Time of admission and mortality after hip fracture: a detailed look at the weekend effect in a nationwide study of 55,211 hip fracture patients in Norway



Time of admission and mortality after hip fracture: a detailed look at the weekend effect in a nationwide study of 55,211 hip fracture patients in Norway



Acta Orthopaedica 89(6): 610-614



Background and purpose - There are numerous studies on the weekend effect for hip fracture patients, with conflicting results. We analyzed time of admission and discharge, and the association with mortality and length of hospital stay in more detail. Patients and methods - We used data from 61,211 surgically treated hip fractures in 55,211 patients, admitted to Norwegian hospitals 2008-2014. All patients were aged 50 years or older. Data were analyzed with Cox and Poisson regression. Results - Mortality within 30 days did not differ substantially by day of admission, although admissions on Sundays and holidays had a slightly increased mortality. The hazard ratios were 1.1 (95% confidence interval [CI] 0.97-1.2) for Sundays, and 1.2 (CI 0.98-1.4) for holidays, relative to Mondays. For patients admitted between 6:00 am and 7:00 am the hazard ratio was 1.4 (CI 1.1-1.8) relative to patients admitted between 2:00 pm and 3:00 pm. Discharges during weekends and holidays were associated with a substantial higher mortality than weekday discharges. Patients admitted from Friday to Sunday generally stayed in hospital for a shorter time than patients admitted during other days. Interpretation - Our results indicate that the discussion on weekday versus weekend admission effects might have distracted attention from other important factors, such as time of day of admission, and day of discharge from hospital treatment.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065954345

Download citation: RISBibTeXText

PMID: 30398406

DOI: 10.1080/17453674.2018.1533769


Related references

The weekend effect: short-term mortality following admission with a hip fracture. Bone and Joint Journal 96-B(3): 373-378, 2014

Re-evaluating the Weekend Effect on SAH: A Nationwide Analysis of the Association Between Mortality and Weekend Admission. Neurocritical Care 30(2): 293-300, 2019

Hip Fracture and the Weekend Effect: Does Weekend Admission Affect Patient Outcomes?. American Journal of Orthopedics 44(10): 458-464, 2015

Effect of Weekend Admission on In-Hospital Mortality in Patients with Ischemic Stroke: An Analysis of Korean Nationwide Claims Data from 2002 to 2013. Journal of Stroke and Cerebrovascular Diseases 25(2): 419-427, 2016

Excess mortality following hip fracture in patients with diabetes according to age: a nationwide population-based cohort study of 154,047 hip fracture patients. Age and Ageing 48(4): 559-563, 2019

Impact of Weekend Admission on Mortality and Other Outcomes among Patients with Burn Injury: A Nationwide Analysis. Journal of the American College of Surgeons 225(4): e180-e181, 2017

Impact of weekend admission on mortality and other outcomes among patients with burn injury: A nationwide analysis. Burns 43(8): 1654-1661, 2017

The influence of renal dialysis and hip fracture sites on the 10-year mortality of elderly hip fracture patients: A nationwide population-based observational study. Medicine 96(37): E7618, 2017

Off-hours admission and quality of hip fracture care: a nationwide cohort study of performance measures and 30-day mortality. International Journal for Quality in Health Care 28(3): 324-331, 2016

Su1476 - Impact of Weekend Admission on Mortality and Other Outcomes Among Patients with Liver Cirrhosis and Spontaneous Bacterial Peritonitis: A Nationwide Analysis. Gastroenterology 154(6): S-532-S-533, 2018

Hip fracture in the elderly: does counting time from fracture to surgery or from hospital admission to surgery matter when studying in-hospital mortality?. Osteoporosis International 20(5): 723-729, 2009

Delay from fracture to hospital admission: a new risk factor for hip fracture mortality?. Osteoporosis International 23(12): 2847-2853, 2012

Effect of admission blood urea and creatinine levels on mortality in elderly patients with hip fracture. Zhongguo Gu Shang 30(10): 901-905, 2017

The Role of Comorbidity in Mortality After Hip Fracture: A Nationwide Norwegian Study of 38,126 Women With Hip Fracture Matched to a General-Population Comparison Cohort. American Journal of Epidemiology 188(2): 398-407, 2019

Effect of a Fracture Liaison Service on the Rate of Subsequent Fracture Among Patients With a Fragility Fracture in the Norwegian Capture the Fracture Initiative (NoFRACT): A Trial Protocol. JAMA Network Open 1(8): E185701, 2018