Admission on weekends does not increase mortality after hip fracture: a meta-analysis of 1.4 million patients

Abstract

Background: The "weekend" effect resulting in increased complication rates in patients admitted on weekends has been noted in many diseases.

Objective: This systematic review and meta-analysis aimed to collate adjusted data from published studies to assess if admission on weekends as compared to weekdays increases mortality rates in hip fracture patients.

Methods: Databases of PubMed, CENTRAL, Scopus, Web of Science, and Embase were searched up to 31^st December 2022 for studies comparing mortality between weekend versus weekday admission of hip fracture patients. Adjusted hazard ratios (HR) were pooled.

Results: Fourteen studies including 1,487,986 patients were analyzed. Most studies were from Europe and North America. Results showed no difference in mortality rates of hip fracture patients admitted on weekends versus weekdays (HR: 1.00 95% 0.96, 1.04 I² = 75%). There was no publication bias and results did not change on the leave-one-out analysis. Subgroup analysis based on sample size and treatment did not change outcomes.

Conclusion: This meta-analysis has shown no apparent weekend effect in cases of hip fractures. Patients admitted on weekends had similar mortality rates as compared to those admitted on weekdays. Current data has high heterogeneity and is mostly from developed countries.

Keywords: Femoral neck fracture; admission; geriatric; hip injury; mortality; weekday.