{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T08:39:40Z","timestamp":1787647180497,"version":"build-2736575974"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T00:00:00Z","timestamp":1637193600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Japan Society for the Promotion of Science (JSPS) KAKENHI","award":["19K19470"],"award-info":[{"award-number":["19K19470"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients admitted on weekends have higher mortality than those admitted on weekdays. However, whether the \u201cweekend effect\u201d results in a higher mortality after admission for acute aortic dissection (AAD),\u2014classified according to Stanford types\u2014remains unclear. This study aimed to examine the association between admission day and in-hospital mortality in AAD Type A and B.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data from the Japanese registry of all Cardiac and Vascular Diseases Diagnostic Procedure Combination, a nationwide claim-based database with data from 953 certified hospitals, and enrolled in-patients with AAD admitted between April 1, 2012, and March 31, 2016. Based on the admission day, we stratified patients into groups (Weekdays, Saturdays, and Sundays\/holidays). The influence of the admission day on in-hospital mortality was assessed via multi-level logistic regression analysis. We also performed a Stanford type-based stratified analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the included 25,641 patients, in-hospital mortality was 16.0%. The prevalence of patients admitted with AAD was relatively higher on weekdays. After adjustment for covariates, patients admitted on a Sunday\/holiday showed an increased risk of in-hospital mortality (odds ratio [OR] 1.20; 95% confidence interval [CI] 1.07\u20131.33, p&lt;0.001) than patients admitted on weekdays. Among patients admitted on a Sunday\/holiday, only the subgroup of Stanford Type A showed a significantly increased risk of in-hospital mortality. (Stanford Type A, non-surgery vs. surgery groups: 95% CI 1.06\u20131.48 vs. 1.17\u20131.68, p&lt;0.001 for both groups, OR 1.25 vs. 1.41, respectively, Stanford Type B, non-surgery vs. surgery groups: 95% CI 0.64\u20131.09 vs. 0.40\u20132.10; p = 0.182 vs. 0.846; OR 0.84 vs. 0.92).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In conclusion, patients with AAD Type A admitted on a Sunday\/holiday may have an increased in-hospital mortality risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0260152","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T13:38:33Z","timestamp":1637242713000},"page":"e0260152","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Effect of holiday admission for acute aortic dissection on in-hospital mortality in Japan: A nationwide study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6796-2464","authenticated-orcid":true,"given":"Katsuhito","family":"Kato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Otsuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michikazu","family":"Nakai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Sumita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Seino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Kawada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"issue":"20","key":"pone.0260152.ref001","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1161\/CIRCULATIONAHA.112.000483","article-title":"Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the Oxford Vascular Study","volume":"127","author":"DP Howard","year":"2013","journal-title":"Circulation"},{"issue":"9","key":"pone.0260152.ref002","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1056\/NEJMsa003376","article-title":"Mortality among patients admitted to hospitals on weekends as compared with weekdays","volume":"345","author":"CM Bell","year":"2001","journal-title":"N Engl J Med"},{"key":"pone.0260152.ref003","doi-asserted-by":"crossref","first-page":"h4596","DOI":"10.1136\/bmj.h4596","article-title":"Increased mortality associated with weekend hospital admission: a case for expanded seven day services?","volume":"351","author":"N Freemantle","year":"2015","journal-title":"BMJ"},{"issue":"6","key":"pone.0260152.ref004","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1097\/MLR.0000000000000532","article-title":"Outcomes are Worse in US Patients Undergoing Surgery on Weekends Compared With Weekdays","volume":"54","author":"LG Glance","year":"2016","journal-title":"Med Care"},{"issue":"5","key":"pone.0260152.ref005","article-title":"Weekday and Survival After Cardiac Surgery-A Swedish Nationwide Cohort Study in 106 473","volume":"6","author":"M Dalen","year":"2017","journal-title":"Patients. 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The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC)","volume":"35","author":"R Erbel","year":"2014","journal-title":"Eur Heart J"},{"issue":"11","key":"pone.0260152.ref012","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1253\/circj.CJ-16-0196","article-title":"The Current Status of Cardiovascular Medicine in Japan- Analysis of a Large Number of Health Records From a Nationwide Claim-Based Database, JROAD-DPC","volume":"80","author":"S Yasuda","year":"2016","journal-title":"Circ J"},{"issue":"10","key":"pone.0260152.ref013","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1161\/CIRCULATIONAHA.118.035858","article-title":"Current Status of Cardiovascular Medicine in the Aging Society of Japan","volume":"138","author":"S Yasuda","year":"2018","journal-title":"Circulation"},{"issue":"10","key":"pone.0260152.ref014","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.je.2016.09.009","article-title":"Validity of diagnoses, procedures, and laboratory data in Japanese administrative data","volume":"27","author":"H Yamana","year":"2017","journal-title":"J Epidemiol"},{"key":"pone.0260152.ref015","doi-asserted-by":"crossref","unstructured":"Summary Results of the National Health and Nutrition Survey Japan, 2012. 2012.","DOI":"10.5402\/2012\/965243"},{"issue":"3","key":"pone.0260152.ref016","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1136\/bmjqs-2018-008219","article-title":"Sicker patients account for the weekend mortality effect among adult emergency admissions to a large hospital trust","volume":"28","author":"J Sun","year":"2019","journal-title":"BMJ Qual Saf"},{"issue":"1","key":"pone.0260152.ref017","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1177\/1355819616649630","article-title":"Higher mortality rates amongst emergency patients admitted to hospital at weekends reflect a lower probability of admission","volume":"22","author":"R Meacock","year":"2017","journal-title":"J Health Serv Res Policy"},{"issue":"8","key":"pone.0260152.ref018","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1097\/CCM.0000000000001015","article-title":"Patient Mortality Is Associated With Staff Resources and Workload in the ICU: A Multicenter Observational Study","volume":"43","author":"A Neuraz","year":"2015","journal-title":"Crit Care Med"},{"issue":"22","key":"pone.0260152.ref019","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1056\/NEJMsa012247","article-title":"Nurse-staffing levels and the quality of care in hospitals","volume":"346","author":"J Needleman","year":"2002","journal-title":"N Engl J Med"},{"issue":"2","key":"pone.0260152.ref020","doi-asserted-by":"crossref","first-page":"73","DOI":"10.7326\/0003-4819-147-2-200707170-00161","article-title":"Changes in hospital mortality associated with residency work-hour regulations","volume":"147","author":"KD Shetty","year":"2007","journal-title":"Annals of internal medicine"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0260152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T13:38:58Z","timestamp":1637242738000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0260152"}},"subtitle":[],"editor":[{"given":"Alessandro","family":"Leone","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,11,18]]},"references-count":20,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0260152","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,18]]}}}