Outcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort study

Abstract Background Studies investigating different medical conditions and settings have demonstrated mixed results regarding the weekend effect. However, data on the outcome of elderly patients hospitalised on weekends is scarce. The objective was to compare in-hospital and two-day mortality rates...

Full description

Bibliographic Details
Main Authors: Steffie H. A. Brouns, Joyce J. Wachelder, Femke S. Jonkers, Suze L. Lambooij, Jeanne P. Dieleman, Harm R. Haak
Format: Article
Language:English
Published: BMC 2018-03-01
Series:BMC Emergency Medicine
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12873-018-0160-y
id doaj-d9f98982fd294dbfbad48429b936c134
record_format Article
spelling doaj-d9f98982fd294dbfbad48429b936c1342020-11-25T00:32:57ZengBMCBMC Emergency Medicine1471-227X2018-03-011811710.1186/s12873-018-0160-yOutcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort studySteffie H. A. Brouns0Joyce J. Wachelder1Femke S. Jonkers2Suze L. Lambooij3Jeanne P. Dieleman4Harm R. Haak5Department of Internal Medicine, Máxima Medical CentreDepartment of Internal Medicine, Máxima Medical CentreDepartment of Internal Medicine, Máxima Medical CentreDepartment of Internal Medicine, Máxima Medical CentreMáxima Medical Centre Academy, Máxima Medical CentreDepartment of Internal Medicine, Máxima Medical CentreAbstract Background Studies investigating different medical conditions and settings have demonstrated mixed results regarding the weekend effect. However, data on the outcome of elderly patients hospitalised on weekends is scarce. The objective was to compare in-hospital and two-day mortality rates between elderly emergency department (ED) patients (≥65 years) admitted on weekends versus weekdays. Methods A retrospective cohort study of emergency department visits of internal medicine patients ≥65 years presenting to the emergency department between 01 and 09-2010 and 31–08-2012 was conducted. The weekend was defined as the period from midnight on Friday to midnight on Sunday. Results Data on 3697 emergency department visits by elderly internal medicine patients (mean age 78.6 years old) were included. In total, 2743 emergency department visits (74.2%) resulted in hospitalisation, of which 22.9% occurred on weekends. Comorbidity and urgency levels were higher in patients admitted on weekends. In-hospital mortality was 11.4% for patients admitted on weekends compared with 8.9% on weekdays (OR 1.3, 95%CI 0.99–1.8). Two-day mortality was 3.2% in patients hospitalised on weekends versus 1.9% on weekdays (OR 1.7, 95%CI 0.99–2.9). Multivariable adjustment for age, comorbidity and triage level demonstrated comparable in-hospital and two-day mortality for weekend and week admission (ORadj 1.2, 95%CI 0.9–1.7 and ORadj 1.5, 95%CI 0.8–2.6, resp.). Conclusion A small weekend effect was observed in elderly internal medicine patients, which was not statistically significant. This effect was partly explained by a higher comorbidity and urgency level in elderly patients hospitalised on weekends than during weekdays. Emergency care for the elderly is not compromised by adjusted logistics during the weekend.http://link.springer.com/article/10.1186/s12873-018-0160-yEmergency servicehospitalAgedOutcome and process assessment (health care)
collection DOAJ
language English
format Article
sources DOAJ
author Steffie H. A. Brouns
Joyce J. Wachelder
Femke S. Jonkers
Suze L. Lambooij
Jeanne P. Dieleman
Harm R. Haak
spellingShingle Steffie H. A. Brouns
Joyce J. Wachelder
Femke S. Jonkers
Suze L. Lambooij
Jeanne P. Dieleman
Harm R. Haak
Outcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort study
BMC Emergency Medicine
Emergency service
hospital
Aged
Outcome and process assessment (health care)
author_facet Steffie H. A. Brouns
Joyce J. Wachelder
Femke S. Jonkers
Suze L. Lambooij
Jeanne P. Dieleman
Harm R. Haak
author_sort Steffie H. A. Brouns
title Outcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort study
title_short Outcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort study
title_full Outcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort study
title_fullStr Outcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort study
title_full_unstemmed Outcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort study
title_sort outcome of elderly emergency department patients hospitalised on weekends - a retrospective cohort study
publisher BMC
series BMC Emergency Medicine
issn 1471-227X
publishDate 2018-03-01
description Abstract Background Studies investigating different medical conditions and settings have demonstrated mixed results regarding the weekend effect. However, data on the outcome of elderly patients hospitalised on weekends is scarce. The objective was to compare in-hospital and two-day mortality rates between elderly emergency department (ED) patients (≥65 years) admitted on weekends versus weekdays. Methods A retrospective cohort study of emergency department visits of internal medicine patients ≥65 years presenting to the emergency department between 01 and 09-2010 and 31–08-2012 was conducted. The weekend was defined as the period from midnight on Friday to midnight on Sunday. Results Data on 3697 emergency department visits by elderly internal medicine patients (mean age 78.6 years old) were included. In total, 2743 emergency department visits (74.2%) resulted in hospitalisation, of which 22.9% occurred on weekends. Comorbidity and urgency levels were higher in patients admitted on weekends. In-hospital mortality was 11.4% for patients admitted on weekends compared with 8.9% on weekdays (OR 1.3, 95%CI 0.99–1.8). Two-day mortality was 3.2% in patients hospitalised on weekends versus 1.9% on weekdays (OR 1.7, 95%CI 0.99–2.9). Multivariable adjustment for age, comorbidity and triage level demonstrated comparable in-hospital and two-day mortality for weekend and week admission (ORadj 1.2, 95%CI 0.9–1.7 and ORadj 1.5, 95%CI 0.8–2.6, resp.). Conclusion A small weekend effect was observed in elderly internal medicine patients, which was not statistically significant. This effect was partly explained by a higher comorbidity and urgency level in elderly patients hospitalised on weekends than during weekdays. Emergency care for the elderly is not compromised by adjusted logistics during the weekend.
topic Emergency service
hospital
Aged
Outcome and process assessment (health care)
url http://link.springer.com/article/10.1186/s12873-018-0160-y
work_keys_str_mv AT steffiehabrouns outcomeofelderlyemergencydepartmentpatientshospitalisedonweekendsaretrospectivecohortstudy
AT joycejwachelder outcomeofelderlyemergencydepartmentpatientshospitalisedonweekendsaretrospectivecohortstudy
AT femkesjonkers outcomeofelderlyemergencydepartmentpatientshospitalisedonweekendsaretrospectivecohortstudy
AT suzellambooij outcomeofelderlyemergencydepartmentpatientshospitalisedonweekendsaretrospectivecohortstudy
AT jeannepdieleman outcomeofelderlyemergencydepartmentpatientshospitalisedonweekendsaretrospectivecohortstudy
AT harmrhaak outcomeofelderlyemergencydepartmentpatientshospitalisedonweekendsaretrospectivecohortstudy
_version_ 1725318053735956480