Timing of Admission to the Surgical Intensive Care Unit is Associated with in-Hospital Mortality
Purpose The relationship between the timing of admission (work-hours or after-hours) to the intensive care unit (ICU) and mortality among surgical ICU (SICU) patients is unclear. This study aimed to investigate whether admission to SICU during after-hours was associated with in-hospital mortality. M...
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| Format: | Article |
| Language: | English |
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Korean Society of Acute Care Surgery
2022-03-01
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| Series: | Journal of Acute Care Surgery |
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| Online Access: | http://www.jacs.or.kr/upload/pdf/jacs-2022-12-1-11.pdf |
| _version_ | 1797681987674177536 |
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| author | Mi Kyoung Kim Eun-Joo Jung Seulkee Park Im-kyung Kim |
| author_facet | Mi Kyoung Kim Eun-Joo Jung Seulkee Park Im-kyung Kim |
| author_sort | Mi Kyoung Kim |
| collection | DOAJ |
| description | Purpose The relationship between the timing of admission (work-hours or after-hours) to the intensive care unit (ICU) and mortality among surgical ICU (SICU) patients is unclear. This study aimed to investigate whether admission to SICU during after-hours was associated with in-hospital mortality. Methods This retrospective cohort study was conducted in a tertiary academic hospital. The data of 571 patients who were admitted to the SICU and whose complete medical records were available were analyzed. Work-hours were defined as 07:00 to 19:00 Monday to Friday, during which the ICU was staffed with intensivists. After-hours were defined as any other time during which the SICU was not staffed with intensivists. The primary outcome measure was in-hospital mortality according to the time of admission (work-hours or after-hours) to the SICU. Results A total of 333 patients, were admitted to the SICU during work-hours, and 238 patients after-hours. Unplanned admissions (47.1% vs. 33.3%, p < 0.001), acute physiology and chronic health evaluation II score ≥ 25 (23.9% vs. 11.1%, p < 0.001), the need for ventilator support (34.0% vs. 17.4%, p < 0.001), and the use of vasopressors (50.0% vs. 33.3%, p < 0.001) were significantly higher in the after-hours group compared with the work-hours group. Multivariate analyses revealed that the timing of SICU admission was an independent predictor of in-hospital mortality (odds ratio, 2.526; 95% confidence interval, 1.010–6.320; p = 0.048). Conclusion This study showed that admission to the SICU during after-hours was associated with increased in-hospital mortality. |
| first_indexed | 2024-03-11T23:53:00Z |
| format | Article |
| id | doaj.art-463d99693b06459aa9c83c88f26912b9 |
| institution | Directory Open Access Journal |
| issn | 2288-5862 2288-9582 |
| language | English |
| last_indexed | 2024-03-11T23:53:00Z |
| publishDate | 2022-03-01 |
| publisher | Korean Society of Acute Care Surgery |
| record_format | Article |
| series | Journal of Acute Care Surgery |
| spelling | doaj.art-463d99693b06459aa9c83c88f26912b92023-09-19T00:01:20ZengKorean Society of Acute Care SurgeryJournal of Acute Care Surgery2288-58622288-95822022-03-01121111710.17479/jacs.2022.12.1.11234Timing of Admission to the Surgical Intensive Care Unit is Associated with in-Hospital MortalityMi Kyoung Kim0Eun-Joo Jung1Seulkee Park2Im-kyung Kim3 Division of Surgical Critical Care, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea Division of Hospital Medicine, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea Division of Hospital Medicine, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea Division of Surgical Critical Care, Department of Surgery, Yonsei University College of Medicine, Seoul, KoreaPurpose The relationship between the timing of admission (work-hours or after-hours) to the intensive care unit (ICU) and mortality among surgical ICU (SICU) patients is unclear. This study aimed to investigate whether admission to SICU during after-hours was associated with in-hospital mortality. Methods This retrospective cohort study was conducted in a tertiary academic hospital. The data of 571 patients who were admitted to the SICU and whose complete medical records were available were analyzed. Work-hours were defined as 07:00 to 19:00 Monday to Friday, during which the ICU was staffed with intensivists. After-hours were defined as any other time during which the SICU was not staffed with intensivists. The primary outcome measure was in-hospital mortality according to the time of admission (work-hours or after-hours) to the SICU. Results A total of 333 patients, were admitted to the SICU during work-hours, and 238 patients after-hours. Unplanned admissions (47.1% vs. 33.3%, p < 0.001), acute physiology and chronic health evaluation II score ≥ 25 (23.9% vs. 11.1%, p < 0.001), the need for ventilator support (34.0% vs. 17.4%, p < 0.001), and the use of vasopressors (50.0% vs. 33.3%, p < 0.001) were significantly higher in the after-hours group compared with the work-hours group. Multivariate analyses revealed that the timing of SICU admission was an independent predictor of in-hospital mortality (odds ratio, 2.526; 95% confidence interval, 1.010–6.320; p = 0.048). Conclusion This study showed that admission to the SICU during after-hours was associated with increased in-hospital mortality.http://www.jacs.or.kr/upload/pdf/jacs-2022-12-1-11.pdfin-hospital mortalityintensive care unitsurgical intensive care |
| spellingShingle | Mi Kyoung Kim Eun-Joo Jung Seulkee Park Im-kyung Kim Timing of Admission to the Surgical Intensive Care Unit is Associated with in-Hospital Mortality Journal of Acute Care Surgery in-hospital mortality intensive care unit surgical intensive care |
| title | Timing of Admission to the Surgical Intensive Care Unit is Associated with in-Hospital Mortality |
| title_full | Timing of Admission to the Surgical Intensive Care Unit is Associated with in-Hospital Mortality |
| title_fullStr | Timing of Admission to the Surgical Intensive Care Unit is Associated with in-Hospital Mortality |
| title_full_unstemmed | Timing of Admission to the Surgical Intensive Care Unit is Associated with in-Hospital Mortality |
| title_short | Timing of Admission to the Surgical Intensive Care Unit is Associated with in-Hospital Mortality |
| title_sort | timing of admission to the surgical intensive care unit is associated with in hospital mortality |
| topic | in-hospital mortality intensive care unit surgical intensive care |
| url | http://www.jacs.or.kr/upload/pdf/jacs-2022-12-1-11.pdf |
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