Association of weekend effect with early mortality in severe sepsis patients over time

Background: The aim of this study is to investigate the "weekend effect" and early mortality of patients with severe sepsis. Methods: Using the Taiwanese National Healthcare Insurance Research Database, all patients who were hospitalized for the first time with an episode of severe sepsis between January 2000 and December 2011 were identified and the short-term mortality of patients admitted on weekdays was compared to those admitted on weekends. The primary endpoint was 7-day mortality. The secondary endpoints were 14 and 28-day mortality. Results: A total of 398,043 patients were identified to have had the diagnosis of severe sepsis. Compared with patients admitted on weekends, patients admitted on weekdays had a lower 7-day mortality rate (adjusted odds ratio [OR] 0.89, 95% confidential interval [CI] 0.87-0.91), 14-day mortality rate (adjusted OR 0.92, 95% CI 0.90-0.93), and 28-day mortality rate (adjusted OR 0.97, 95% CI 0.95-0.98). This "weekend effect" was maintained every year throughout the 11-year study period. Conclusions: Patients with severe sepsis are more likely to die in the hospital if they were admitted on weekends than if they were admitted on weekdays. (C) 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.