title: Silent night: retrospective database study assessing possibility of "weekend effect" in palliative care.
abstract: OBJECTIVE
  To compare the mortality of patients in a palliative care unit on working days with that on weekends and public holidays.
  
  
  METHODS
  Retrospective database study.
  
  
  METHODS
  Palliative care unit in Germany.
  
  
  METHODS
  All admissions to palliative care unit between 1 January 1997 and 31 December 2008.
  
  
  METHODS
  The impact of day type (working days or weekends and public holidays) on mortality was analysed using Poisson regression models.
  
  
  RESULTS
  A total of 2565 admitted patients and 1325 deaths were recorded. Of the deaths, 448 (33.8%) occurred on weekends and public holidays. The mortality rate on weekends and public holidays was 18% higher than that on working days (mortality rate ratio 1.18, 95% confidence interval 1.05 to 1.32; P=0.005).
  
  
  CONCLUSIONS
  Patients in the palliative care unit were at higher risk of dying on weekends and public holidays. In the absence of a prospective study, the exact reasons for this correlation are unclear.
authors.affiliation: Department of Palliative Care, University Hospital Cologne, Cologne, Germany.
authors.forename: Raymond
authors.initials: R
authors.lastname: Voltz
authors.affiliation: Department of Palliative Care, Medical Clinic of St Katharinen Hospital, Frechen, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Kamps
authors.affiliation: Department of Palliative Care, University Hospital Cologne, Cologne, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Greinwald
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Hellmich
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Hamacher
authors.affiliation: Department of Palliative Care, University Hospital Freiburg, 79106 Freiburg, Germany Competence Center Palliative Care, Baden-Württemberg, Germany.
authors.forename: Gerhild
authors.initials: G
authors.lastname: Becker
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Kuhr
authors.affiliation: Department of Palliative Care, University Hospital Freiburg, 79106 Freiburg, Germany Competence Center Palliative Care, Baden-Württemberg, Germany jan.gaertner@uniklinik-freiburg.de.
authors.forename: Jan
authors.initials: J
authors.lastname: Gaertner
mesh_terms: D039602:After-Hours Care; D005260:Female; D005858:Germany / Q000453:epidemiology; D006693:Holidays; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D010166:Palliative Care; D012189:Retrospective Studies; D018570:Risk Assessment; D019452:Terminally Ill; D013997:Time Factors