title: The weekend effect: short-term mortality following admission with a hip fracture.
abstract: We retrospectively reviewed 2989 consecutive patients with a mean age of 81 (21 to 105) and a female to male ratio of 5:2 who were admitted to our hip fracture unit between July 2009 and February 2013. We compared weekday and weekend admission and weekday and weekend surgery 30-day mortality rates for hip fractures treated both surgically and conservatively. After adjusting for confounders, weekend admission was independently and significantly associated with a rise in 30-day mortality (odds ratio (OR) 1.4, 95% confidence interval (CI) 1.02 to 1.9; p = 0.039) for patients undergoing hip fracture surgery. There was no increase in mortality associated with weekend surgery (OR 1.2, 95% CI 0.8 to 1.7; p = 0.39). All hip fracture patients, whether managed surgically or conservatively, were more likely to die as an inpatient when admitted at the weekend (OR 1.4, 95% CI 1.02 to 1.80; p = 0.032), despite our unit having a comparatively low overall inpatient mortality (8.7%). Hip fracture patients admitted over the weekend appear to have a greater risk of death despite having a consultant-led service.
authors.affiliation: University Hospitals of Leicester NHS Trust, Infirmary Square, LE1 5WW, UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: Thomas
authors.forename: R P
authors.initials: RP
authors.lastname: Smith
authors.forename: C E
authors.initials: CE
authors.lastname: Uzoigwe
authors.forename: J R
authors.initials: JR
authors.lastname: Braybrooke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004739:England / Q000453:epidemiology; D005260:Female; D006620:Hip Fractures / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Hip fracture; Mortality; Weekend; day of admission; day of surgery; orthogeriatrician