An association between weekend (WE) admission and worst patients’ outcomes has been reported, independently from countries and health system organizations. This study aimed to evaluated the relationship between WE effect, IHM and gender in patients admitted to hospital for any cause. Analysis included all admissions between January 1, 2000, and December 31, 2013, to the General Hospital, Ferrara, Italy. During the study period, 411,588 hospital admissions in 208,010 patients (90% from the ED) were considered. Males were 47% (mean age: 53.3±27.1 years) and females 53% (mean age: 53.6±26.4 years). Of these patients, 14,006 (6.7%) died during hospitalization. As for patients admitted during WE or WD, age (53.5±28.6 vs. 53.5±26.3 years), and prevalence of females was similar (17.7% vs. 17.2%), whereas CCI was significantly higher (1.16±1.90 vs. 1.13±1.89, p<0.001) in subjects admitted during WE. Univariate analysis showed that IHM was related to age (75.1±14.9 vs 52.7±26.7, p<0.001), CCI (3.05±2.86 vs 1.07±1.81, p<0.001), WE admission (WE 4.7% vs. WD 3.1%, p<0.001), and male sex (3.9% vs. 3%, p<0.001). Logistic regression analysis revealed an independent association between IHM and age (OR=1.052, p<0.001), male sex (OR=1.251, p<0.001), admission during WE (OR=1.413; p<0.001), and CCI (OR=1.276; p<0.001). A separate analysis was performed on the subgroup of subjects admitted during WE (n=71,965, 33,380 males, 46.4%, mean age 53±28.7 years; 38,585 females, 53.6%, mean age 53.9±28.6), showing that IHM group had higher age (76±15.2 vs. 52.4±28.7 years, p<0.001), higher prevalence of male sex (5.2% vs. 4.3%, p<0.001), and higher CCI (2.91±2.74 vs. 1.08±1.81, p<0.001) than survivors. Multivariate analysis confirmed that, in WE patients, IHM was independently related to age, male sex, and CCI. Gender seems to be an important risk factor for IHM, independently from age and CCI.
Weekend hospitalization and inhospital mortality: a gender effect?
FABBIAN, Fabio;TISEO, Ruana;ZUCCHI, Beatrice;SIGNANI, Fulvia;MANFREDINI, Roberto
2015
Abstract
An association between weekend (WE) admission and worst patients’ outcomes has been reported, independently from countries and health system organizations. This study aimed to evaluated the relationship between WE effect, IHM and gender in patients admitted to hospital for any cause. Analysis included all admissions between January 1, 2000, and December 31, 2013, to the General Hospital, Ferrara, Italy. During the study period, 411,588 hospital admissions in 208,010 patients (90% from the ED) were considered. Males were 47% (mean age: 53.3±27.1 years) and females 53% (mean age: 53.6±26.4 years). Of these patients, 14,006 (6.7%) died during hospitalization. As for patients admitted during WE or WD, age (53.5±28.6 vs. 53.5±26.3 years), and prevalence of females was similar (17.7% vs. 17.2%), whereas CCI was significantly higher (1.16±1.90 vs. 1.13±1.89, p<0.001) in subjects admitted during WE. Univariate analysis showed that IHM was related to age (75.1±14.9 vs 52.7±26.7, p<0.001), CCI (3.05±2.86 vs 1.07±1.81, p<0.001), WE admission (WE 4.7% vs. WD 3.1%, p<0.001), and male sex (3.9% vs. 3%, p<0.001). Logistic regression analysis revealed an independent association between IHM and age (OR=1.052, p<0.001), male sex (OR=1.251, p<0.001), admission during WE (OR=1.413; p<0.001), and CCI (OR=1.276; p<0.001). A separate analysis was performed on the subgroup of subjects admitted during WE (n=71,965, 33,380 males, 46.4%, mean age 53±28.7 years; 38,585 females, 53.6%, mean age 53.9±28.6), showing that IHM group had higher age (76±15.2 vs. 52.4±28.7 years, p<0.001), higher prevalence of male sex (5.2% vs. 4.3%, p<0.001), and higher CCI (2.91±2.74 vs. 1.08±1.81, p<0.001) than survivors. Multivariate analysis confirmed that, in WE patients, IHM was independently related to age, male sex, and CCI. Gender seems to be an important risk factor for IHM, independently from age and CCI.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
