{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T03:04:42Z","timestamp":1792292682584,"version":"4.4.0"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,3,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">A considerable amount of studies have examined the relationship between off\u2010hours (weekends and nights) admission and mortality risk for various diseases, but the results remain equivocal.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Through a search of\n              <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>\n              ,\n              <jats:styled-content style=\"fixed-case\">PUBMED<\/jats:styled-content>\n              , Web of Science, and Cochrane Database of Systematic Reviews, we identified cohort studies that evaluated the association between off\u2010hour admission and mortality risk for disease. In a random effects meta\u2010analysis of 140 identified articles (251 cohorts), off\u2010hour admission was strongly associated with increased mortality for aortic aneurysm (odds ratio, 1.52; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.30\u20131.77), breast cancer (1.50, 1.21\u20131.86), leukemia (1.45, 1.17\u20131.79), respiratory neoplasm (1.32, 1.20\u20131.26), pancreatic cancer (1.32, 1.12\u20131.56), malignant neoplasm of genitourinary organs (1.27, 1.08\u20131.49), colorectal cancer (1.26, 1.07\u20131.49), pulmonary embolism (1.20, 1.13\u20131.28), arrhythmia and cardiac arrest (1.19, 1.09\u20131.29), and lymphoma (1.19, 1.06\u20131.34). Weaker (odds ratio &lt;1.19) but statistically significant association was noted for renal failure, traumatic brain injury, heart failure, intracerebral hemorrhage, subarachnoid hemorrhage, stroke, gastrointestinal bleeding, myocardial infarction, chronic obstructive pulmonary disease, and bloodstream infections. No association was found for hip fracture, pneumonia, intestinal obstruction, aspiration pneumonia, peptic ulcer, trauma, diverticulitis, and neonatal mortality. Overall, off\u2010hour admission was associated with increased mortality for 28 diseases combined (odds ratio, 1.11; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.10\u20131.13).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Off\u2010hour admission is associated with increased mortality risk, and the associations varied substantially for different diseases. Specialists, nurses, as well as hospital administrators and health policymakers can take these findings into consideration to improve the quality and continuity of medical services.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.115.003102","type":"journal-article","created":{"date-parts":[[2016,3,19]],"date-time":"2016-03-19T04:15:57Z","timestamp":1458360957000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":85,"title":["Off\u2010Hour Admission and Mortality Risk for 28 Specific Diseases: A Systematic Review and Meta\u2010Analysis of 251 Cohorts"],"prefix":"10.1161","volume":"5","author":[{"given":"Yanfeng","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzhen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chulani","family":"Herath","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahong","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fujian","family":"Song","sequence":"additional","affiliation":[{"name":"Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyi","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuxun","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2012.825"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa063355"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2011.106"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa003376"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa012247"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.7.803"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1179\/1743132813Y.0000000263"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-011-1932-1"},{"key":"e_1_3_4_10_2","unstructured":"Agency for Health care Research and Quality . Guide to inpatient quality indicators: quality of care in hospital\u2010volume mortality and utilization. Available at: http:\/\/qualityindicators.ahrq.gov\/downloads\/modules\/iqi\/v31\/iqi_guide_v31.pdf. Accessed March 12 2007."},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.6153.1670"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1981.tb01197.x"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2004.02.035"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f7393"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2014.03.012"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-010-9491-z"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-013-1316-8"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02478-8"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-11-200212030-00007"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.04.065"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.752113"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25086"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.824292"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-009-0914-1"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2014.01.043"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.7.785"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2011.02.007"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2012.747926"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/ael012"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04562.x"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181f6f958"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2011.60"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa052049"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2013-002218"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.22.2958"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752-2897-3-8"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2009.02067.x"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-012-2463-7"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyl284"},{"key":"e_1_3_4_44_2","first-page":"337","article-title":"Risks of stillbirth and early neonatal death by day of week","volume":"170","author":"Luo ZC","year":"2004","unstructured":"Luo ZC, Liu S, Wilkins R, Kramer MS. Risks of stillbirth and early neonatal death by day of week. CMAJ. 2004;170:337\u2013341.","journal-title":"CMAJ"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-0456"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1177\/0884217503258306"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.115.003102","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:20:22Z","timestamp":1715595622000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.115.003102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,9]]},"references-count":45,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2016,3,9]]}},"alternative-id":["10.1161\/JAHA.115.003102"],"URL":"https:\/\/doi.org\/10.1161\/jaha.115.003102","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3,9]]},"assertion":[{"value":"2016-01-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-02-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-03-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e003102"}}