Intern Med J. 2022 Feb 21. doi: 10.1111/imj.15723. Online ahead of print.
ABSTRACT
BACKGROUND: Previous studies demonstrated a ‘weekend effect’ and a ‘night effect’ of increased mortality among patients admitted during weekends or night shifts, presumably due to understaffing. In this study, we rather examined whether death during hospitalization follows a similar effect regardless of admission time.
METHODS: A retrospective cohort study among deceased patients hospitalized in the internal medicine wing of a tertiary medical center in Israel, between 2019-2020. Demographic and medical data were retrieved from electronic medical charts. Causes of death were specifically catogrized. We applied statistical models to test for differences in mortality using incidence rate ratio (IRR) according to the day, time and cause of death.
RESULTS: 1,278 deceased patients were included. All-cause mortality was similar among weekends and weekdays. When sepsis was the cause of death, higher IRR were demonstrated on Fridays in comparison to weekdays (IRR 1.4 95% CI 1.1-1.9, p<0.05). Other causes of death were not consistent with a ‘weekend effect’. Mortality during nightshifts was higher in comparison to the afternoon (IRR 1.5 95% CI 1.3-4.7) and similar to the morning (IRR 1 95% CI 0.9-1.2).
CONCLUSION: Our study did not find a pattern of ‘weekend effect’ or ‘night effect’ on all-cause mortality among hospitalized patients in internal medicine wards. Our findings suggests that perhaps specifically death from sepsis, and not all-cause mortality, can be used as a surrogate for the measurement of understaffing or quality of care in the internal ward. This article is protected by copyright. All rights reserved.
PMID:35189020 | DOI:10.1111/imj.15723
