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Abstract
We aimed to determine whether hospital admissions during an extended holiday period (Chinese New Year) and weekends were associated with increased mortality risk from pulmonary embolism (PE), compared to admissions on weekdays. We conducted a nationwide retrospective cohort study using Taiwan’s National Health Insurance Research Database. Data of newly diagnosed PEs during the months of January and February from 2001 to 2017 were obtained from patient records and classified into three admission groups: Chinese New Year (≥ 4 consecutive holiday days), weekends, and weekdays. The adjusted odds ratios (aORs) (95% confidence intervals [CIs]) for 7-day and in-hospital mortality were calculated using multivariable logistic regression models. The 7-day and in-hospital mortality risks were higher for patients admitted during the Chinese New Year holiday (10.6% and 18.7%) compared to those admitted on weekends (8.4% and 16.1%) and weekdays (6.6% and 13.8%). These higher mortality risks for holiday admissions compared to weekday admissions were confirmed by multivariable analysis (7-day mortality: aOR = 1.68, 95% CI 1.15–2.44, P = 0.007; in-hospital mortality: aOR = 1.41, 95% CI 1.05–1.90, P = 0.022), with no subgroup effects by sex or age. Hospital admission for PE over an extended holiday period, namely Chinese New Year, was associated with an increased risk of mortality.
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1 Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Department of Family Medicine, Hualien, Taiwan, ROC; Taipei Veterans General Hospital, Department of Psychiatry, Taipei, Taiwan, ROC (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314)
2 Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Department of Physical Medicine and Rehabilitation, Hualien, Taiwan, ROC (GRID:grid.278247.c); Tzu Chi University, School of Medicine, Hualien, Taiwan, ROC (GRID:grid.411824.a) (ISNI:0000 0004 0622 7222)
3 Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Center for Aging and Health, Hualien, Taiwan, ROC (GRID:grid.411824.a); Tzu Chi University, Institute of Medical Sciences, Hualien, Taiwan, ROC (GRID:grid.411824.a) (ISNI:0000 0004 0622 7222)
4 Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Department of Anesthesiology, Hualien, Taiwan, ROC (GRID:grid.411824.a)
5 Tzu Chi University, School of Medicine, Hualien, Taiwan, ROC (GRID:grid.411824.a) (ISNI:0000 0004 0622 7222); Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Center for Aging and Health, Hualien, Taiwan, ROC (GRID:grid.411824.a)
6 Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Department of Orthopedics, Hualien, Taiwan, ROC (GRID:grid.411824.a)
7 Far Eastern Memorial Hospital, Department of Psychiatry, New Taipei City, Taiwan, ROC (GRID:grid.414746.4) (ISNI:0000 0004 0604 4784)
8 Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Department of Family Medicine, Hualien, Taiwan, ROC (GRID:grid.414746.4); Tzu Chi University, School of Medicine, Hualien, Taiwan, ROC (GRID:grid.411824.a) (ISNI:0000 0004 0622 7222); Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Department of Medical Research, Hualien, Taiwan, ROC (GRID:grid.411824.a)