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- Publisher Website: 10.1093/qjmed/hcy012
- Scopus: eid_2-s2.0-85045523836
- PMID: 29361145
- WOS: WOS:000429470500008
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Article: Adding a new dimension to the weekend effect: An analysis of a national data set of electronic AKI alerts
Title | Adding a new dimension to the weekend effect: An analysis of a national data set of electronic AKI alerts |
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Authors | |
Issue Date | 2018 |
Citation | QJM, 2018, v. 111, n. 4, p. 249-255 How to Cite? |
Abstract | © The Author(s) 2018. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. Background: Increased mortality related to differences in delivery of weekend clinical care is the subject of much debate. Aim: We compared mortality following detection of acute kidney injury (AKI) on week and weekend days across community and hospital settings. Design: A prospective national cohort study, with AKI identified using the Welsh National electronic AKI reporting system. Methods: Data were collected on outcome for all cases of adult AKI in Wales between 1 November 2013 and 31 January 2017. Results: There were a total of 107 298 episodes. Weekday detection of AKI was associated with 28.8% (26 439); 90-day mortality compared to 90-day mortality of 31.9% (4551) for AKI detected on weekdays (RR: 1.11, 95% CI: 1.08-1.14, P<0.001, HR: 1.16 95% CI: 1.12-1.20, P<0.001). There was no 'weekend effect' for mortality associated with hospital-acquired AKI. Weekday detection of community-acquired AKI (CA-AKI) was associated with a 22.6% (10 356) mortality compared with weekend detection of CA-AKI, which was associated with a 28.6% (1619) mortality (RR: 1.26, 95% CI: 1.21-1.32, P<0.001, HR: 1.34, 95%CI: 1.28-1.42, P<0.001). The excess mortality in weekend CA-AKI was driven by CA-AKI detected at the weekend that was not admitted to hospital compared with CA-AKI detected on weekdays which was admitted to hospital (34.5% vs. 19.1%, RR: 1.8, 95% CI: 1.69-1.91, P<0.001, HR: 2.03, 95% CI: 1.88-2.19, P<0.001). Conclusion: 'Weekend effect' in AKI relates to access to in-patient care for patients presenting predominantly to hospital emergency departments with AKI at the weekend. |
Persistent Identifier | http://hdl.handle.net/10722/293084 |
ISSN | 2023 Impact Factor: 7.3 2023 SCImago Journal Rankings: 0.626 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Holmes, J. | - |
dc.contributor.author | Rainer, T. | - |
dc.contributor.author | Geen, J. | - |
dc.contributor.author | Williams, J. D. | - |
dc.contributor.author | Phillips, A. O. | - |
dc.date.accessioned | 2020-11-17T14:57:50Z | - |
dc.date.available | 2020-11-17T14:57:50Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | QJM, 2018, v. 111, n. 4, p. 249-255 | - |
dc.identifier.issn | 1460-2725 | - |
dc.identifier.uri | http://hdl.handle.net/10722/293084 | - |
dc.description.abstract | © The Author(s) 2018. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. Background: Increased mortality related to differences in delivery of weekend clinical care is the subject of much debate. Aim: We compared mortality following detection of acute kidney injury (AKI) on week and weekend days across community and hospital settings. Design: A prospective national cohort study, with AKI identified using the Welsh National electronic AKI reporting system. Methods: Data were collected on outcome for all cases of adult AKI in Wales between 1 November 2013 and 31 January 2017. Results: There were a total of 107 298 episodes. Weekday detection of AKI was associated with 28.8% (26 439); 90-day mortality compared to 90-day mortality of 31.9% (4551) for AKI detected on weekdays (RR: 1.11, 95% CI: 1.08-1.14, P<0.001, HR: 1.16 95% CI: 1.12-1.20, P<0.001). There was no 'weekend effect' for mortality associated with hospital-acquired AKI. Weekday detection of community-acquired AKI (CA-AKI) was associated with a 22.6% (10 356) mortality compared with weekend detection of CA-AKI, which was associated with a 28.6% (1619) mortality (RR: 1.26, 95% CI: 1.21-1.32, P<0.001, HR: 1.34, 95%CI: 1.28-1.42, P<0.001). The excess mortality in weekend CA-AKI was driven by CA-AKI detected at the weekend that was not admitted to hospital compared with CA-AKI detected on weekdays which was admitted to hospital (34.5% vs. 19.1%, RR: 1.8, 95% CI: 1.69-1.91, P<0.001, HR: 2.03, 95% CI: 1.88-2.19, P<0.001). Conclusion: 'Weekend effect' in AKI relates to access to in-patient care for patients presenting predominantly to hospital emergency departments with AKI at the weekend. | - |
dc.language | eng | - |
dc.relation.ispartof | QJM | - |
dc.title | Adding a new dimension to the weekend effect: An analysis of a national data set of electronic AKI alerts | - |
dc.type | Article | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1093/qjmed/hcy012 | - |
dc.identifier.pmid | 29361145 | - |
dc.identifier.scopus | eid_2-s2.0-85045523836 | - |
dc.identifier.volume | 111 | - |
dc.identifier.issue | 4 | - |
dc.identifier.spage | 249 | - |
dc.identifier.epage | 255 | - |
dc.identifier.eissn | 1460-2393 | - |
dc.identifier.isi | WOS:000429470500008 | - |
dc.identifier.issnl | 1460-2393 | - |