RT Journal Article
SR Electronic
T1 Effect of Weekend Admission on Hip Fracture Mortality
JF Ochsner Journal
JO Ochsner J
FD O. P. Jindal Global University
SP 2
OP 10
DO 10.31486/toj.24.0017
VO 25
IS 1
A1 Newcomb, Nicholas L.
A1 Urvater, Marlena
A1 Doig, Ian E.
A1 Mullen, Michael
A1 Cooke, Cameron M.
YR 2025
UL http://www.ochsnerjournal.org/content/25/1/2.abstract
AB Background Weekend vs weekday hospital admission has been associated with poorer mortality rates for many conditions. Studies evaluating weekend admission for hip fractures have resulted in contradictory conclusions regarding outcomes.Methods We conducted a retrospective analysis of all patients who underwent surgery for a fragility hip fracture at a quaternary level teaching hospital during a 6-year period. A total of 1,164 patients were included: 796 weekday admissions (Monday through Friday) vs 368 weekend admissions (Saturday and Sunday). Patients were subdivided based on surgeon experience level (473 consultants vs 690 nonconsultants). Statistical tests included chi-square tests and logistic regression. Demographic data included age, sex, prior hip fracture, fracture type, operation, and American Society of Anesthesiologists grade. The primary outcome was 1-year mortality. Secondary outcomes were acute mortality (<24 hours), subacute mortality (1 to 30 days), change in mobility from baseline at 1 year, preoperative delay (>48 hours), and surgical duration.Results The weekend admission cohort had a higher 1-year mortality rate than the weekday admission cohort (30.4% vs 23.2%; P=0.029), while subacute mortality trended toward significance (P=0.083). No significant difference was seen in acute mortality (P=0.5). Hemiarthroplasty was associated with increased mortality at 12 months (P=0.012) compared to the other operative interventions. The median duration of surgery was lower in the weekend cohort vs the weekday cohort (1.15 hours [69 minutes] vs 1.23 hours [73.8 minutes]; P<0.001). Consultants performed surgeries 16.2 minutes faster than nonconsultants (P<0.001) and trended toward a lower 1-year mortality rate (22.1% vs 27.9%; P=0.058). No significant difference was seen in mobility change at 1 year in both the consultant vs nonconsultant analysis (P>0.9) and in the weekday vs weekend analysis (P>0.12).Conclusion A significantly increased 1-year mortality rate and a shorter surgical duration were observed among patients admitted on the weekends.