Admission Time and Outcomes of Patients in A Medical Intensive Care Unit
Studies have shown that weekend or night admissions to intensive care units (ICUs) are associated with increased mortality in critically ill patients. Our study aimed to evaluate the effects of admission time and day on patient outcomes in a medical ICU equipped with patient management guidelines, a...
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2007-08-01
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| Series: | Kaohsiung Journal of Medical Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0257565507700032 |
| _version_ | 1818863479465967616 |
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| author | Chau-Chyun Sheu Jong-Rung Tsai Jen-Yu Hung Chih-Jen Yang Hsin-Chia Hung Inn-Wen Chong Ming-Shyan Huang Jhi-Jhu Hwang |
| author_facet | Chau-Chyun Sheu Jong-Rung Tsai Jen-Yu Hung Chih-Jen Yang Hsin-Chia Hung Inn-Wen Chong Ming-Shyan Huang Jhi-Jhu Hwang |
| author_sort | Chau-Chyun Sheu |
| collection | DOAJ |
| description | Studies have shown that weekend or night admissions to intensive care units (ICUs) are associated with increased mortality in critically ill patients. Our study aimed to evaluate the effects of admission time and day on patient outcomes in a medical ICU equipped with patient management guidelines, and staffed by intensivists on call for 24 hours, who led the morning rounds on all days of the week but did not stay in-house overnight. The study enrolled 611 consecutive patients admitted to a 26-bed medical ICU in a university hospital during a 7-month period. We divided them into two groups, which we labeled as “office hours” (08:00–18:00 on weekdays) and “non-office hours” (18:00–08:00 on weekdays, and all times on weekends) according to their ICU admission times. The clinical outcomes were compared between the groups. The effects of admission on weekends, at night, and various days of the week on hospital mortality were also evaluated. Our results showed that there were no significant differences in ICU and hospital mortalities between patients admitted during office hours and those admitted during non-office hours (27.2% vs. 27.4%, p = 1.000; 38.9% vs. 37.6%, p = 0.798). The ICU length of stay, ICU-free time within 21 days, and length of stay in the hospital were also comparable in both groups. Among the 392 patients requiring mechanical ventilation, the ventilator outcomes were not significantly different between those in the office-hour group and the non-office-hour group. Multivariate logistic regression analyses showed that the adjusted odds of hospital mortality were not significantly higher for patients admitted to our ICU on weekends, at night, or on any days of the week. In conclusion, our results showed that non-office-hour admissions to our medical ICU were not associated with poorer ICU, hospital, and ventilator outcomes, compared with office-hour admissions. Neither were time of day and day of the week admissions to our ICU associated with significant differences in hospital mortality. |
| first_indexed | 2024-12-19T10:16:25Z |
| format | Article |
| id | doaj.art-aeeec262e2a24cff99ddd2625cc6a042 |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-12-19T10:16:25Z |
| publishDate | 2007-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-aeeec262e2a24cff99ddd2625cc6a0422022-12-21T20:26:12ZengWileyKaohsiung Journal of Medical Sciences1607-551X2007-08-0123839540410.1016/S0257-5655(07)70003-2Admission Time and Outcomes of Patients in A Medical Intensive Care UnitChau-Chyun Sheu0Jong-Rung Tsai1Jen-Yu Hung2Chih-Jen Yang3Hsin-Chia Hung4Inn-Wen Chong5Ming-Shyan Huang6Jhi-Jhu Hwang7Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, KaohsiungDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, KaohsiungDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, KaohsiungDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, KaohsiungGraduate Institute of Health Care, Meiho Institute of Technology, Pingtung, TaiwanDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, KaohsiungDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, KaohsiungDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, KaohsiungStudies have shown that weekend or night admissions to intensive care units (ICUs) are associated with increased mortality in critically ill patients. Our study aimed to evaluate the effects of admission time and day on patient outcomes in a medical ICU equipped with patient management guidelines, and staffed by intensivists on call for 24 hours, who led the morning rounds on all days of the week but did not stay in-house overnight. The study enrolled 611 consecutive patients admitted to a 26-bed medical ICU in a university hospital during a 7-month period. We divided them into two groups, which we labeled as “office hours” (08:00–18:00 on weekdays) and “non-office hours” (18:00–08:00 on weekdays, and all times on weekends) according to their ICU admission times. The clinical outcomes were compared between the groups. The effects of admission on weekends, at night, and various days of the week on hospital mortality were also evaluated. Our results showed that there were no significant differences in ICU and hospital mortalities between patients admitted during office hours and those admitted during non-office hours (27.2% vs. 27.4%, p = 1.000; 38.9% vs. 37.6%, p = 0.798). The ICU length of stay, ICU-free time within 21 days, and length of stay in the hospital were also comparable in both groups. Among the 392 patients requiring mechanical ventilation, the ventilator outcomes were not significantly different between those in the office-hour group and the non-office-hour group. Multivariate logistic regression analyses showed that the adjusted odds of hospital mortality were not significantly higher for patients admitted to our ICU on weekends, at night, or on any days of the week. In conclusion, our results showed that non-office-hour admissions to our medical ICU were not associated with poorer ICU, hospital, and ventilator outcomes, compared with office-hour admissions. Neither were time of day and day of the week admissions to our ICU associated with significant differences in hospital mortality.http://www.sciencedirect.com/science/article/pii/S0257565507700032admissioncritical careintensive care unitmortalitytime factor |
| spellingShingle | Chau-Chyun Sheu Jong-Rung Tsai Jen-Yu Hung Chih-Jen Yang Hsin-Chia Hung Inn-Wen Chong Ming-Shyan Huang Jhi-Jhu Hwang Admission Time and Outcomes of Patients in A Medical Intensive Care Unit Kaohsiung Journal of Medical Sciences admission critical care intensive care unit mortality time factor |
| title | Admission Time and Outcomes of Patients in A Medical Intensive Care Unit |
| title_full | Admission Time and Outcomes of Patients in A Medical Intensive Care Unit |
| title_fullStr | Admission Time and Outcomes of Patients in A Medical Intensive Care Unit |
| title_full_unstemmed | Admission Time and Outcomes of Patients in A Medical Intensive Care Unit |
| title_short | Admission Time and Outcomes of Patients in A Medical Intensive Care Unit |
| title_sort | admission time and outcomes of patients in a medical intensive care unit |
| topic | admission critical care intensive care unit mortality time factor |
| url | http://www.sciencedirect.com/science/article/pii/S0257565507700032 |
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