• Joe Feinglass, D Mark Courtney, Rahul K Khare, and Emilie S Powell.
• Department of Emergency Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Institute for Healthcare Studies and Division of General Internal Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
• J Emerg Med. 2013 Nov 1;45(5):641-8.

BackgroundMortality differences in weekend and weekday admissions have been observed for a variety of conditions that require aggressive early intervention. It is unknown if there is a mortality difference that exists for patients presenting to the Emergency Department (ED) with sepsis on the weekend.Study ObjectivesWe hypothesized that there is an increase in early inpatient mortality (death on day 1 or day 2 of hospitalization) among patients with sepsis who present to the ED on the weekend vs. weekdays.MethodsWe performed a cross-sectional analysis of 114,611 ED admissions with a principal diagnosis consistent with sepsis from 576 hospitals in the 2008 Nationwide Inpatient Sample. Adjusted analyses controlled for patient and hospital characteristics, and examined the likelihood of either early (day 1 or day 2 of hospitalization) or overall inpatient mortality.ResultsA greater proportion of patients admitted on the weekend died on day 1 and day 2 of hospitalization (5.4% vs. 4.0%, p < 0.001; and 7.5% vs. 6.9%, p = 0.001), the difference for overall inpatient mortality was not significant (17.9% vs. 17.5%, p = 0.08). The risk-adjusted odds ratio (OR) of day 1 and day 2 early inpatient mortality of weekend vs. weekday admissions was 1.10 (95% confidence interval [CI] 1.04-1.17) and 1.08 (95% CI 1.03-1.14), respectively; the association with overall inpatient mortality was not significant (OR 1.03, 95% CI 1.00-1.07).ConclusionsPatients admitted through the ED with sepsis on the weekend had a greater likelihood of early mortality, but not overall mortality, when compared to patients admitted on weekdays.Copyright © 2013 Elsevier Inc. All rights reserved.

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