title: In-patient hospital mortality patterns by day of the week: an analysis of admissions to a regional renal unit.
abstract: OBJECTIVE
  Higher mortality rates have been reported for patients admitted at a weekend compared to a weekday. Our aim was to assess in-patient mortality patterns by day of the week, in a tertiary renal unit.
  
  
  RESULTS
  Mortality related to day of admission and day of death was analysed over a two-year period at Glasgow Western Infirmary renal unit. Typical caseload was also assessed over two random four-week periods. As a proportion of admissions, 30-day mortality was 46/540 (8.5%) on a weekend day compared with a weekday 107/2013 (5.3%) (RR1.60, p = 0.005). Thirty-day mortality rate was 46/208 = 0.22 deaths/weekend day of admission compared with 107/523 = 0.20 deaths/weekday of admission (incident rate ratio = 1.08, p = 0.67). There was no significant increased risk of death on a weekend day compared to a weekday (RR1.23, p = 0.23). A higher proportion of weekend admissions were from other hospitals. Acute kidney injury and haemodialysis patients formed a higher percentage of admissions.
  
  
  CONCLUSIONS
  Admission day mortality expressed as a death rate/day does not differ between weekend/weekday admissions. Admission day mortality expressed as a proportion of total admissions was significantly higher at weekends. This suggests admission case-mix/workload differs at weekends with fewer 'well' patients admitted. In-patient mortality patterns are complex and any conclusions made should take into account case mix and workload.
authors.affiliation: Clinical Teaching Fellow, Monklands Hospital, UK rosemaryhaddock@nhs.net.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Haddock
authors.affiliation: Consultant Nephrologist, Renal Unit, Queen Elizabeth University Hospital, Glasgow, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Deighan
authors.affiliation: Consultant Nephrologist, Renal Unit, Queen Elizabeth University Hospital, Glasgow, UK.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Thomson
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality*; D039602:After-Hours Care / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D010343:Patient Admission; D006435:Renal Dialysis / Q000401:mortality* / Q000706:statistics & numerical data; D018570:Risk Assessment; D012606:Scotland / Q000453:epidemiology; D013997:Time Factors
keywords: Mortality; Scottish; nephrology; weekend admissions