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Background: Sepsis is associated with detrimental clinical outcomes. It requires early diagnosis and urgent therapeutic intervention. Because staffing during after-hours is limited, we explored whether after-hour admissions are associated with worse clinical outcomes in patients with sepsis. Methods: In this cohort study, we analysed nationwide acute care admissions for a main diagnosis of sepsis in Switzerland between 2006 and 2016 using prospective administrative data. The primary outcome was in-hospital mortality using multivariate logistic regression models. Secondary outcomes were intensive care unit (ICU) admission, intubation, and 30-day readmission. Findings: We included 86`597 hospitalisations for sepsis, 60·1% admitted during routine-hours, 16·8% on weekends and 23·1% at night. Compared to routine-hour admissions, we found a higher risk for in-hospital mortality in patients admitted on weekends (20·0% vs. 19·2%, adjusted odds ratio [OR] 1·05, 95% confidence interval [95% CI] 1·01-1·10, p=0·029). Also, the risk for ICU admission (30·5% vs. 28·0%, OR 1·14, 95% CI 1·10-1·19, p |
