title: Patient outcomes following after-hours and weekend admissions for cardiovascular disease in a tertiary hospital in Calabar, Nigeria.
abstract: BACKGROUND
  There are various reports of higher mortality rates occurring after admissions over the weekend and during after-hours. This study aimed to determine if there was a difference in mortality rates occurring during the weekend and after-hours among cardiovascular admissions in a tertiary hospital in Nigeria.
  
  
  METHODS
  A review of cardiovascular admissions (including stroke) was carried out at the University of Calabar Teaching Hospital in Nigeria from January 2010 to December 2013. All admissions to the medical wards from the emergency department and medical out-patient department clinics during the study period were included.
  
  
  RESULTS
  A total of 339 patients were studied and stroke was the commonest type of cardiovascular disease (CVD) admitted (187; 55.2%). Hypertension was the commonest cause of heart failure (70; 48.6%). Presentation to hospital during after-hours and length of stay of more than 14 days were significant predictors of death (OR: 3.37; 0.22).
  
  
  CONCLUSIONS
  An increase in CVD mortality rates occurred during after-hours, most likely a consequence of uneven staffing patterns and poor access to equipment. Healthcare providers in Nigeria need to consider remedies to this with a view to reducing excess mortality rates.
authors.affiliation: Cardiology Unit, Department of Internal Medicine, University of Calabar, Calabar, Cross River State, Nigeria. Email: vic_ansa@yahoo.com.
authors.forename: Victor
authors.initials: V
authors.lastname: Ansa
authors.affiliation: Department of Internal Medicine, University of Calabar, Calabar, Cross River State, Nigeria.
authors.forename: Akaninyene
authors.initials: A
authors.lastname: Otu
authors.affiliation: Department of Community Medicine, University of Calabar, Calabar, Cross River State, Nigeria.
authors.forename: Affiong
authors.initials: A
authors.lastname: Oku
authors.affiliation: Cardiology Unit, Department of Internal Medicine, University of Calabar, Calabar, Cross River State, Nigeria.
authors.forename: Uchenna
authors.initials: U
authors.lastname: Njideoffor
authors.affiliation: Cardiology Unit, Department of Internal Medicine, University of Calabar, Calabar, Cross River State, Nigeria.
authors.forename: Charles
authors.initials: C
authors.lastname: Nworah
authors.affiliation: Cardiology Unit, Department of Internal Medicine, University of Calabar, Calabar, Cross River State, Nigeria.
authors.forename: Clement
authors.initials: C
authors.lastname: Odigwe
mesh_terms: D000328:Adult; D039602:After-Hours Care; D000368:Aged; D016507:Cardiology Service, Hospital; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016009:Chi-Square Distribution; D005260:Female; D006297:Health Services Accessibility; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D016017:Odds Ratio; D010343:Patient Admission; D010561:Personnel Staffing and Scheduling; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome