0
Correspondence |

Mortality Associated With Nonelective Hospital Admission

Javier Marco, PhD; Raquel Barba, PhD; Antonio Zapatero, PhD
Arch Surg. 2011;146(12):1451. doi:10.1001/archsurg.2011.957.
Text Size: A A A
Published online

Extract

We have read with interest the article by Ricciardi et al1 entitled “Mortality Rate After Noelective Hospital Admission” that presented data demonstrating significantly worse outcomes after nonelective admission during the weekend compared with weekdays across demographic groups for 16 of 25 medical and surgical diagnoses. The work was done using data from nearly 30 million admissions coming from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, which contains data from approximately 7 to 8 million hospital stays per year in 1000 hospitals in 35 states. We have recently published a similar work about the weekend effect on acute exacerbations of patients with chronic obstructive pulmonary disease.2 Previous studies on the subject failed to demonstrate this type of effect, probably owing to a problem with the size of the sample.3 However, using also a large clinical, administrative database obtained from the Spanish Ministry of Health, we were able to include nearly 390 000 patients and to identify differences in mortality that persisted after adjustment for age, sex, and coexisting disorders (odds ratio, 1.05 [95% CI, 1.02-1.08]) between patients admitted on weekdays and patients admitted on weekends. We would like to stress the importance and validity of the research done with this type of large administrative, clinical database. It can be argued (and we would agree) that this type of research has some drawbacks for the analysis of specific clinical outcomes. However, this type of research is invaluable for reaching conclusions about clinical problems in which the size of the sample is crucial.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
JAMAevidence.com


Mortality

brightcove.createExperiences();