The Weekend Effect in Older Adult Urosepsis Admissions

Urosepsis is common in older adults with more infections identified as community-acquired as opposed to hospital-acquired. Despite the prevalence of urosepsis and its high mortality rates, very little is known about the care outcomes of older adult patients with community-acquired urosepsis who are admitted to the hospital on a weekend.

To determine if a weekend admission was associated with inpatient mortality in older adults admitted to an acute care hospital with a diagnosis of community-acquired urosepsis.

Data from the State Inpatient Datasets for Florida were merged with data from the American Hospital Association Annual Survey on hospital characteristics for the year 2014. Logistic regression models with a sizable number of patient and hospital controls were used to identify factors associated with inpatient mortality in patients 65 years of age and older with a primary or secondary diagnosis of community-acquired urosepsis.

In total 21,904 older adults were admitted to a Florida hospital with a diagnosis of community-acquired urosepsis; 5736 of these patients were admitted on a weekend. In a fully adjusted logistic regression model, weekend admission was associated with a 12% increase in the odds of mortality, and each additional hour of nursing care per patient day was associated with a 2% decrease in the odds of mortality.

Our findings suggest that weekend admission was associated with an increase in the odds of mortality in older adults with community-acquired urosepsis. Small increases in nurse staffing seem to reduce the odds of mortality.