title: Weekend hospital admission, acute kidney injury, and mortality.
abstract: Admission to the hospital on weekends is associated with increased mortality for several acute illnesses. We investigated whether patients admitted on a weekend with acute kidney injury (AKI) were more likely to die than those admitted on a weekday. Using the Nationwide Inpatient Sample, a large database of admissions to acute care, nonfederal hospitals in the United States, we identified 963,730 admissions with a diagnosis of AKI between 2003 and 2006. Of these, 214,962 admissions (22%) designated AKI as the primary reason for admission (45,203 on a weekend and 169,759 on a weekday). We used logistic regression models to examine the adjusted odds of in-hospital mortality associated with weekend versus weekday admission. Compared with admission on a weekday, patients admitted with a primary diagnosis of AKI on a weekend had a higher odds of death [adjusted odds ratio (OR) 1.07, 95% confidence interval (CI) 1.02 to 1.12]. The risk for death with admission on a weekend for AKI was more pronounced in smaller hospitals (adjusted OR 1.17, 95% CI 1.03 to 1.33) compared with larger hospitals (adjusted OR 1.07, 95% CI 1.01 to 1.13). Increased mortality was also associated with weekend admission among patients with AKI as a secondary diagnosis across a spectrum of co-existing medical diagnoses. In conclusion, among patients hospitalized with AKI, weekend admission is associated with a higher risk for death compared with admission on a weekday.
authors.affiliation: Department of Medicine, University of Calgary, Alberta, Canada.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: James
authors.forename: Ron
authors.initials: R
authors.lastname: Wald
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
authors.forename: Marcello
authors.initials: M
authors.lastname: Tonelli
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Hemmelgarn
authors.forename: Sushrut S
authors.initials: SS
authors.lastname: Waikar
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Chertow
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality*; D015897:Comorbidity; D017052:Hospital Mortality; D006801:Humans; D010343:Patient Admission / Q000706:statistics & numerical data*; D018570:Risk Assessment; D013997:Time Factors; D014481:United States / Q000453:epidemiology
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