{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T04:17:45Z","timestamp":1748405865091,"version":"3.41.0"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Medical and Health Science and Technology Program Project Fund of Zhejiang Province","award":["No. 2021KY1131"],"award-info":[{"award-number":["No. 2021KY1131"]}]},{"name":"the Provincial Medical and Health Technology Project","award":["Grant WKJ-ZJ-2315"],"award-info":[{"award-number":["Grant WKJ-ZJ-2315"]}]},{"DOI":"10.13039\/501100019066","name":"Tianjin Municipal Transportation Commission Science and Technology Development Plan Project","doi-asserted-by":"publisher","award":["Grant 202204A10"],"award-info":[{"award-number":["Grant 202204A10"]}],"id":[{"id":"10.13039\/501100019066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Numerous studies have shown that patients admitted on weekends or holidays have higher mortality rates and poorer prognoses than those admitted on weekdays. However, the specific impact of the weekend effect on patients with sepsis remains unclear and requires further investigation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This study included adult patients with sepsis who were first admitted to the ICU and stayed for \u226524 hours, using data from the Medical Information Mart for Intensive Care (MIMIC)-IV (version 2.2),with the data collection period from 2008 to 2019. Data on age, gender, type of ICU admission, vital signs, disease severity scores, and medications were collected, with patients categorized into weekend and weekday admission groups. The primary outcome was 28-day mortality, while secondary outcomes included 90-day mortality, hospital mortality, ICU mortality, and survival days without vasoactive drugs, ventilator, or ICU stay. COX regression analyses with propensity score matching (PSM) were employed to assess the impact of weekend admissions on the survival of septic patients in the ICU.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 20,261 septic patients met the inclusion criteria, with 14,469 in the weekday group and 5,792 in the weekend group. The weekend admission group showed no statistically significant differences in 28-day mortality, hospital mortality, ICU mortality, survival days without vasoactive drugs, survival days without ventilator, survival days without ICU, and length of ICU stay compared to the weekday group. Subgroup analyses for 28-day mortality revealed that key baseline characteristics such as gender, age, BMI, race, ICU type, hypertension, diabetes mellitus, and SOFA score did not independently influence the prognosis of patients with sepsis based on weekend admission.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The study found no significant weekend effect on the prognosis of septic patients admitted to the ICU, based on both univariate and multivariate analyses.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0324288","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T17:27:32Z","timestamp":1748366852000},"page":"e0324288","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The weekend effect on 28-day mortality in septic patients admitted to the ICU: A retrospective study from the MIMIC-IV database"],"prefix":"10.1371","volume":"20","author":[{"given":"Jianmin","family":"Qu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingting","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyu","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Congcong","family":"Lv","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiayi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6810-5750","authenticated-orcid":true,"given":"Shuhao","family":"Que","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"pone.0324288.ref001","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.0324288.ref002","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s00038-020-01443-x","article-title":"Holiday and weekend effects on mortality for acute myocardial infarction in Shanxi, China: a cross-sectional study","volume":"65","author":"X Lin","year":"2020","journal-title":"Int J Public Health"},{"issue":"19","key":"pone.0324288.ref003","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1161\/CIRCULATIONAHA.116.024535","article-title":"\u201cWeekend Effect\u201d or \u201cSaturday Effect\u201d? An analysis of hospital mortality for patients with ischemic stroke in South Carolina","volume":"134","author":"L Shi","year":"2016","journal-title":"Circulation"},{"issue":"1","key":"pone.0324288.ref004","doi-asserted-by":"crossref","first-page":"69","DOI":"10.4103\/tcmj.tcmj_20_22","article-title":"The impact of holiday season and weekend effect on traumatic injury mortality: Evidence from a 10-year analysis","volume":"35","author":"P-C Lin","year":"2022","journal-title":"Tzu Chi Med J"},{"issue":"1","key":"pone.0324288.ref005","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1046\/j.1525-1497.1999.00284.x","article-title":"Weekend work. Balancing competing interests","volume":"14","author":"C Tanio","year":"1999","journal-title":"J Gen Intern Med"},{"issue":"4","key":"pone.0324288.ref006","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1378\/chest.126.4.1292","article-title":"The hospital mortality of patients admitted to the ICU on weekends","volume":"126","author":"SA Ensminger","year":"2004","journal-title":"Chest"},{"issue":"12","key":"pone.0324288.ref007","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1007\/s00134-003-2035-1","article-title":"The effects of ICU admission and discharge times on mortality in Finland","volume":"29","author":"A Uusaro","year":"2003","journal-title":"Intensive Care Med"},{"issue":"2","key":"pone.0324288.ref008","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1097\/CCM.0000000000002837","article-title":"The effect of ICU out-of-hours admission on mortality: a systematic review and meta-analysis","volume":"46","author":"M Galloway","year":"2018","journal-title":"Crit Care Med"},{"issue":"8","key":"pone.0324288.ref009","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"M Singer","year":"2016","journal-title":"JAMA"},{"issue":"3","key":"pone.0324288.ref010","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1164\/rccm.201504-0781OC","article-title":"Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations","volume":"193","author":"C Fleischmann","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"issue":"3","key":"pone.0324288.ref011","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-069824","article-title":"Development and validation of a nomogram for predicting in-hospital mortality of elderly patients with persistent sepsis-associated acute kidney injury in intensive care units: a retrospective cohort study using the MIMIC-IV database","volume":"13","author":"W Jiang","year":"2023","journal-title":"BMJ Open"},{"key":"pone.0324288.ref012","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jcrc.2021.07.015","article-title":"Effects of ondansetron use on outcomes of acute kidney injury in critically ill patients: an analysis based on the MIMIC-IV database","volume":"66","author":"L Tao","year":"2021","journal-title":"J Crit Care"},{"issue":"8","key":"pone.0324288.ref013","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1001\/jama.2016.0289","article-title":"Developing a new definition and assessing new clinical criteria for septic shock: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"M Shankar-Hari","year":"2016","journal-title":"JAMA"},{"issue":"10141","key":"pone.0324288.ref014","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(18)30696-2","article-title":"Sepsis and septic shock","volume":"392","author":"M Cecconi","year":"2018","journal-title":"Lancet"},{"issue":"9","key":"pone.0324288.ref015","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1056\/NEJM200108303450911","article-title":"Why do hospital death rates vary?","volume":"345","author":"EA Halm","year":"2001","journal-title":"N Engl J Med"},{"issue":"2","key":"pone.0324288.ref016","doi-asserted-by":"crossref","first-page":"115","DOI":"10.4997\/JRCPE.2010.205","article-title":"Mortality in out-of-hours emergency medical admissions--more than just a weekend effect","volume":"40","author":"F Maggs","year":"2010","journal-title":"J R Coll Physicians Edinb"},{"issue":"3","key":"pone.0324288.ref017","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1097\/01.CCM.0000203947.60552.DD","article-title":"Weekend and weeknight admissions have the same outcome of weekday admissions to an intensive care unit with onsite intensivist coverage","volume":"34","author":"Y Arabi","year":"2006","journal-title":"Crit Care Med"},{"issue":"3","key":"pone.0324288.ref018","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1097\/01.CCM.0000055378.31408.26","article-title":"Hospital mortality rate and length of stay in patients admitted at night to the intensive care unit","volume":"31","author":"IJ Morales","year":"2003","journal-title":"Crit Care Med"},{"issue":"3","key":"pone.0324288.ref019","doi-asserted-by":"crossref","DOI":"10.1186\/cc7904","article-title":"Off hour admission to an intensivist-led ICU is not associated with increased mortality","volume":"13","author":"IA Meynaar","year":"2009","journal-title":"Crit Care"},{"issue":"1","key":"pone.0324288.ref020","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1186\/s12913-020-5029-6","article-title":"Severity of illness and the weekend mortality effect: a retrospective cohort study","volume":"20","author":"E Bressman","year":"2020","journal-title":"BMC Health Serv Res"},{"issue":"8","key":"pone.0324288.ref021","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/S0257-5655(07)70003-2","article-title":"Admission time and outcomes of patients in a medical intensive care unit","volume":"23","author":"C-C Sheu","year":"2007","journal-title":"Kaohsiung J Med Sci"},{"issue":"5","key":"pone.0324288.ref022","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1007\/s00134-004-2170-3","article-title":"Hospital mortality associated with day and time of admission to intensive care units","volume":"30","author":"H Wunsch","year":"2004","journal-title":"Intensive Care Med"},{"issue":"1","key":"pone.0324288.ref023","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/01.CCM.0000249832.36518.11","article-title":"Mortality among patients admitted to intensive care units during weekday day shifts compared with \u201coff\u201d hours","volume":"35","author":"C-E Luyt","year":"2007","journal-title":"Crit Care Med"},{"issue":"16","key":"pone.0324288.ref024","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1001\/jama.288.16.1987","article-title":"Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction","volume":"288","author":"LH Aiken","year":"2002","journal-title":"JAMA"},{"issue":"9301","key":"pone.0324288.ref025","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0140-6736(02)07366-X","article-title":"Patient volume, staffing, and workload in relation to risk-adjusted outcomes in a random stratified sample of UK neonatal intensive care units: a prospective evaluation","volume":"359","author":"UK Neonatal Staffing Study Group","year":"2002","journal-title":"Lancet"},{"issue":"3","key":"pone.0324288.ref026","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1097\/01.CCM.0000117317.18092.E4","article-title":"Surviving sepsis campaign guidelines for management of severe sepsis and septic shock","volume":"32","author":"Surviving Sepsis Campaign Management Guidelines Committee","year":"2004","journal-title":"Crit Care Med"},{"issue":"11","key":"pone.0324288.ref027","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021","volume":"47","author":"L Evans","year":"2021","journal-title":"Intensive Care Med"},{"issue":"10089","key":"pone.0324288.ref028","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/S0140-6736(17)30782-1","article-title":"Mortality risks associated with emergency admissions during weekends and public holidays: an analysis of electronic health records","volume":"390","author":"AS Walker","year":"2017","journal-title":"Lancet"},{"issue":"1","key":"pone.0324288.ref029","doi-asserted-by":"crossref","first-page":"12533","DOI":"10.1038\/s41598-019-48947-y","article-title":"Time of day and its association with risk of death and chance of discharge in critically ill patients: a retrospective study","volume":"9","author":"P Zajic","year":"2019","journal-title":"Sci Rep"},{"issue":"5","key":"pone.0324288.ref030","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1177\/106286060101600503","article-title":"A comparison of predictive outcomes of APACHE II and SAPS II in a surgical intensive care unit","volume":"16","author":"J McNelis","year":"2001","journal-title":"Am J Med Qual"},{"issue":"11","key":"pone.0324288.ref031","doi-asserted-by":"crossref","first-page":"1793","DOI":"10.1097\/00003246-199811000-00016","article-title":"Use of the SOFA score to assess the incidence of organ dysfunction\/failure in intensive care units: results of a multicenter, prospective study. Working group on \u201csepsis-related problems\u201d of the European Society of Intensive Care Medicine","volume":"26","author":"JL Vincent","year":"1998","journal-title":"Crit Care Med"},{"issue":"1","key":"pone.0324288.ref032","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1177\/0885066620981902","article-title":"Association between afterhours discharge from the intensive care unit and hospital mortality: a multi-center retrospective cohort study","volume":"37","author":"A Hall","year":"2022","journal-title":"J Intensive Care Med"},{"issue":"6","key":"pone.0324288.ref033","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1007\/s001340100966","article-title":"Mortality after discharge from intensive care: the impact of organ system failure and nursing workload use at discharge","volume":"27","author":"R Moreno","year":"2001","journal-title":"Intensive Care Med"},{"issue":"3","key":"pone.0324288.ref034","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1164\/rccm.201611-2250ST","article-title":"An Official American Thoracic Society Systematic Review: the effect of nighttime intensivist staffing on mortality and length of stay among intensive care unit patients","volume":"195","author":"MP Kerlin","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"pone.0324288.ref035","doi-asserted-by":"crossref","DOI":"10.1016\/j.jtcvs.2014.02.074","article-title":"The benefits of 24\/7 in-house intensivist coverage for prolonged-stay cardiac surgery patients","volume":"148","author":"K Kumar","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"2","key":"pone.0324288.ref036","doi-asserted-by":"crossref","first-page":"134","DOI":"10.14797\/mdcj-14-2-134","article-title":"Is 24\/7 in-house intensivist staffing necessary in the intensive care unit?","volume":"14","author":"F Masud","year":"2018","journal-title":"Methodist Debakey Cardiovasc J"},{"issue":"6","key":"pone.0324288.ref037","first-page":"449","article-title":"Physician staffing and shift work schedules: concepts for emergency and intensive care medicine","volume":"115","author":"W Behringer","year":"2020","journal-title":"Med Klin Intensivmed Notfmed"},{"issue":"4","key":"pone.0324288.ref038","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.chest.2024.04.012","article-title":"ICU staffing in the United States","volume":"166","author":"HB Gershengorn","year":"2024","journal-title":"Chest"},{"issue":"22","key":"pone.0324288.ref039","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1056\/NEJMsa1201918","article-title":"Nighttime intensivist staffing and mortality among critically ill patients","volume":"366","author":"DJ Wallace","year":"2012","journal-title":"N Engl J Med"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0324288","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T17:27:40Z","timestamp":1748366860000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0324288"}},"subtitle":[],"editor":[{"given":"Fadi","family":"Aljamaan","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,27]]},"references-count":39,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0324288","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,27]]}}}