Effect of Out-Of-Hour Admission on Fluid Treatment of Emergency Department Patients with Suspected Infection; a Multicenter Post-Hoc Analysis
Introduction: Sepsis is a life-threatening and common cause of Emergency department (ED) referrals. Out-of-hour staffing is limited in ED, which may potentially affect fluid administration. This study aimed to investigate fluid volume variation in out-of-hour vs. routine-hour admissions. Methods...
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| Format: | Article |
| Language: | English |
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Shahid Beheshti University of Medical Sciences
2023-01-01
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| Series: | Archives of Academic Emergency Medicine |
| Subjects: | |
| Online Access: | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1839 |
| _version_ | 1828048438878535680 |
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| author | Marie Kristine Jessen Anna Drescher Petersen Hans Kirkegaard |
| author_facet | Marie Kristine Jessen Anna Drescher Petersen Hans Kirkegaard |
| author_sort | Marie Kristine Jessen |
| collection | DOAJ |
| description |
Introduction: Sepsis is a life-threatening and common cause of Emergency department (ED) referrals. Out-of-hour staffing is limited in ED, which may potentially affect fluid administration. This study aimed to investigate fluid volume variation in out-of-hour vs. routine-hour admissions.
Methods: The present study is a post-hoc analysis of a multicentre, prospective, observational study investigating fluid administration in ED patients with suspected infection, from Jan 20th - March 2nd, 2020. Patient groups were “routine-hours” (RH): weekdays 07:00-18:59 or “out-of-hours” (OOH): weekdays 19:00-06:59 or Friday 19:00-Monday 06:59. Primary outcome was 24-hour total fluid volumes (oral + intravenous (IV)). Secondary outcomes were total fluids 0-6 hours, oral fluids 0-6 and 0-24 hours, and IV fluids 0-6 and 0-24 hours. Linear regression adjusted for site and illness severity was used.
Results: 734 patients had suspected infection; 449 were admitted during RH and 287 during OOH. Mean (95% CI) total 24-hour fluid volumes were equal in simple infection and sepsis regardless of admission time: Simple infection RH: 3640 (3410 - 3871) ml and OOH: 3681 (3451 - 3913) ml. Sepsis RH: 3671 (3443;3898) ml and OOH: 3896 (3542;4250) ml. Oral fluids 0-6h were reduced in simple infection and sepsis among OOH vs. RH. Sepsis patients received more 0-6-hour IV fluid when admitted OOH vs. RH. There were no associations between admission time and 0-24-hour oral or IV volumes in simple infection or sepsis.
Conclusion: Admission time did not have an association with 24-hour total fluid volumes. Sepsis patients admitted during OOH received more 0-6-hour IV fluids than RH patients, and simple infection and sepsis patients received less oral fluid in 0-6 hours if admitted during OOH vs. RH.
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| first_indexed | 2024-04-10T18:56:24Z |
| format | Article |
| id | doaj.art-01a82837b484498b95212ccbc06e4940 |
| institution | Directory Open Access Journal |
| issn | 2645-4904 |
| language | English |
| last_indexed | 2024-04-10T18:56:24Z |
| publishDate | 2023-01-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Archives of Academic Emergency Medicine |
| spelling | doaj.art-01a82837b484498b95212ccbc06e49402023-01-31T18:04:18ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042023-01-0111110.22037/aaem.v11i1.1839Effect of Out-Of-Hour Admission on Fluid Treatment of Emergency Department Patients with Suspected Infection; a Multicenter Post-Hoc Analysis Marie Kristine Jessen0Anna Drescher Petersen1Hans Kirkegaard2Research Center for Emergency Medicine, Aarhus University and University HospitalResearch Center for Emergency Medicine, Aarhus University and University HospitalResearch Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital Introduction: Sepsis is a life-threatening and common cause of Emergency department (ED) referrals. Out-of-hour staffing is limited in ED, which may potentially affect fluid administration. This study aimed to investigate fluid volume variation in out-of-hour vs. routine-hour admissions. Methods: The present study is a post-hoc analysis of a multicentre, prospective, observational study investigating fluid administration in ED patients with suspected infection, from Jan 20th - March 2nd, 2020. Patient groups were “routine-hours” (RH): weekdays 07:00-18:59 or “out-of-hours” (OOH): weekdays 19:00-06:59 or Friday 19:00-Monday 06:59. Primary outcome was 24-hour total fluid volumes (oral + intravenous (IV)). Secondary outcomes were total fluids 0-6 hours, oral fluids 0-6 and 0-24 hours, and IV fluids 0-6 and 0-24 hours. Linear regression adjusted for site and illness severity was used. Results: 734 patients had suspected infection; 449 were admitted during RH and 287 during OOH. Mean (95% CI) total 24-hour fluid volumes were equal in simple infection and sepsis regardless of admission time: Simple infection RH: 3640 (3410 - 3871) ml and OOH: 3681 (3451 - 3913) ml. Sepsis RH: 3671 (3443;3898) ml and OOH: 3896 (3542;4250) ml. Oral fluids 0-6h were reduced in simple infection and sepsis among OOH vs. RH. Sepsis patients received more 0-6-hour IV fluid when admitted OOH vs. RH. There were no associations between admission time and 0-24-hour oral or IV volumes in simple infection or sepsis. Conclusion: Admission time did not have an association with 24-hour total fluid volumes. Sepsis patients admitted during OOH received more 0-6-hour IV fluids than RH patients, and simple infection and sepsis patients received less oral fluid in 0-6 hours if admitted during OOH vs. RH. https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1839Emergency service, hospitalfluid therapysepsisinfectionstime factorsperiodicity |
| spellingShingle | Marie Kristine Jessen Anna Drescher Petersen Hans Kirkegaard Effect of Out-Of-Hour Admission on Fluid Treatment of Emergency Department Patients with Suspected Infection; a Multicenter Post-Hoc Analysis Archives of Academic Emergency Medicine Emergency service, hospital fluid therapy sepsis infections time factors periodicity |
| title | Effect of Out-Of-Hour Admission on Fluid Treatment of Emergency Department Patients with Suspected Infection; a Multicenter Post-Hoc Analysis |
| title_full | Effect of Out-Of-Hour Admission on Fluid Treatment of Emergency Department Patients with Suspected Infection; a Multicenter Post-Hoc Analysis |
| title_fullStr | Effect of Out-Of-Hour Admission on Fluid Treatment of Emergency Department Patients with Suspected Infection; a Multicenter Post-Hoc Analysis |
| title_full_unstemmed | Effect of Out-Of-Hour Admission on Fluid Treatment of Emergency Department Patients with Suspected Infection; a Multicenter Post-Hoc Analysis |
| title_short | Effect of Out-Of-Hour Admission on Fluid Treatment of Emergency Department Patients with Suspected Infection; a Multicenter Post-Hoc Analysis |
| title_sort | effect of out of hour admission on fluid treatment of emergency department patients with suspected infection a multicenter post hoc analysis |
| topic | Emergency service, hospital fluid therapy sepsis infections time factors periodicity |
| url | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1839 |
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