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Weekend mortality for emergency admissions. A large, multicentre study
  1. P Aylin1,
  2. A Yunus1,
  3. A Bottle1,
  4. A Majeed1,
  5. D Bell2
  1. 1Dr Foster Unit at Imperial College, Department of Primary Care and Social Medicine, Imperial College London, London, UK
  2. 2Department of Medicine, Imperial College London, Chelsea and Westminster Campus, London, UK
  1. Correspondence to Dr Paul Aylin, Dr Foster Unit at Imperial, Department of Primary Care and Social Medicine, Imperial College London, London SW7 2AZ, UK; p.aylin{at}


Background Several studies have identified higher mortality for patients admitted as emergencies at the weekend compared with emergency admissions during the week, but most have focused on specific conditions or have had a limited sample size.

Methods Using routinely collected hospital administrative data, we examined in-hospital deaths for all emergency inpatient admissions to all public acute hospitals in England for 2005/2006. Odds of death were calculated for admissions at the weekend compared to admissions during the week, adjusted for age, sex, socioeconomic deprivation, comorbidity and diagnosis.

Results Of a total of 4 317 866 emergency admissions, we found 215 054 in-hospital deaths with an overall crude mortality rate of 5.0% (5.2% for all weekend admissions and 4.9% for all weekday admissions). The overall adjusted odds of death for all emergency admissions was 10% higher (OR 1.10, 95% CI 1.08 to 1.11) in those patients admitted at the weekend compared with patients admitted during a weekday (p<0.001).

Conclusions This is the largest study published on weekend mortality and highlights an area of concern in relation to the delivery of acute services.

  • Mortality
  • epidemiology
  • health services research
  • hospital
  • routine data
  • quality of care
  • health care quality
  • statistics
  • patient outcomes

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  • Funding PA and AB are employed within the Dr Foster Unit at Imperial. The Dr Foster Unit at Imperial College London is funded by a grant from Dr Foster Intelligence (an independent health service research organisation). The Dr Foster Unit at Imperial is affiliated with the Imperial Centre for Patient Safety and Service Quality at Imperial College Healthcare NHS Trust, which is funded by the National Institute of Health Research. The Department of Primary Care and Social Medicine is grateful for support from the National Institute for Health Research Biomedical Research Centre Funding Scheme.

  • Competing interests None.

  • Ethics approval The Dr Foster Unit at Imperial has approval from St Mary's NHS trust local research ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.