Evidence map›Paper›PMID 42337650›Full record

SynthesisJournal of health, population, and nutrition2026

Effect of off-hours admission on in-hospital mortality in sub-Saharan Africa: a systematic review and meta-analysis.

Tilahun Degu Tsega, Almaw Genet Yeshiwas, Tewodros Worku Bogale, Chalachew Yenew, Gashaw Melkie Bayeh, Ahmed Fentaw Ahmed, Meron Asmamaw Alemayehu, Abathun Temesgen, Wei Ma

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of health, population, and nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Tilahun Degu TsegaDepartment of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. mkdt2121@gmail.com.ORCID 0000-0002-2388-3171
Almaw Genet YeshiwasDepartment of environmental health, college of medicine and health sciences, Injibara university, Injibara, Ethiopia.
Tewodros Worku BogaleSchool of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
Chalachew YenewDepatment of Public Health, College of health science, Debre Tabor University, Debre Tabor, Ethiopia.
Gashaw Melkie BayehDepartment of environmental health, college of medicine and health sciences, Injibara university, Injibara, Ethiopia.
Ahmed Fentaw AhmedDepartment of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
Meron Asmamaw AlemayehuDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Abathun TemesgenDepartment of environmental health, college of medicine and health sciences, Injibara university, Injibara, Ethiopia.
Wei MaDepartment of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. weima@sdu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe findings of previous works of literature on the effects of off-hours admission on in-hospital mortality in sub-Saharan Africa were inconsistent and inconclusive. However, there is paucity of information as single summarized finding. Therefore, this review aimed to determine the pooled effects of off-hours admission on the in-hospital mortality in sub-Saharan Africa.

methodsA systematic review and meta-analysis were conducted using studies from PubMed, MEDLINE, Cochrane Library, Web of Science, African Journals Online, and Google Scholar up to 30/12/2025. Study quality, heterogeneity and publication bias were assessed accordingly. Pooled estimates were estimated using a random-effects model. Subgroup and sensitivity analyses were performed. Odds ratios with 95% confidence intervals were used to quantify the association between off-hours admission and in-hospital mortality.

resultsThis review included 14 primary studies. The pooled magnitude of off-hours in-hospital mortality among all hospital admissions in sub-Saharan Africa was 12.39% (95% CI: 9.76, 15.02%). The nighttime mortality among the nighttime admissions was 26.1% (95%CI: 18.6, 33.6%). Besides, the pooled weekend's in-hospital mortality among weekends' admissions in sub-Saharan Africa was 31.5% (95% CI: 23.5, 39.5%). The pooled effects of off-hours admission on in-hospital mortality was higher for weekend admission (OR = 1.22, 95% CI: 1.01, 1.47) and nighttime admission (OR = 2.36, 95% CI: 1.40, 4.00) compared with weekday admission.

conclusionsOff-hours admission may be associated with increased mortality; however, the findings should be interpreted cautiously due to substantial heterogeneity and variability in study definitions. REGISTRATION: The protocol was registered at PROSPERO with reg. no "CRD42024621339".

Indexed as

After-Hours CareHospitalizationHospital MortalityPatient AdmissionAfrica South of the SaharaHumansIn-hospital mortalityNighttime admissionOff-hoursSub-Saharan AfricaWeekend’s admission

Identifiers

PMID42337650
PMCPMC13576359

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.