- 作者：A. Abella ; C. Hermosa ; V. Enciso ; I. Torrejó ; n ; R. Molina ; I. Salinas ; M. Dí ; az ; T. Mozo ; F. Gordo ; fgordo5@gmail.com" class="auth_mail" title="E-mail the corresponding author
- 关键词：Early diagnosis ; Decision support techniques ; Hospital rapid response team ; Outcome ; Critical care ; Time admission
- 刊名：Medicina Intensiva (English Edition)
- 出版年：2016
- 出版时间：January-February 2016
- 年：2016
- 卷：40
- 期：1
- 页码：26-32
- 全文大小：601 K
Design
A prospective, observational, non-interventional cohort study was carried out.
Scope
A second level hospital with 210 operational beds and a general ICU with 8 operational beds.
Patients or participants
The study comprised all patients admitted to the ICU during 3 years (January 2010 to December 2012), excluding those subjects admitted from the operating room after scheduled surgery. The patients were divided into 2 groups according to the timing of admission (on-hours or off-hours).
Interventions
Non-interventional study.
Variables of interest
An analysis was made of demographic variables (age, sex), origin (emergency room, hospital ward, operating room), comorbidities and SAPS 3 as severity score upon admission, length of stay in the ICU and hospital ward, and ICU and hospital mortality.
Results
A total of 504 patients were included in the on-hours group, versus 602 in the off-hours group. Multivariate analysis showed the factors independently associated to hospital mortality to be SAPS 3 (OR 1.10; 95%CI 1.08–1.12), and off-hours admission (OR 2.00; 95%CI 1.20–3.33). In a subgroup analysis of the off-hours group, the admission of patients on weekends or non-working days compared to daily night shifts was found to be independently associated to hospital mortality (OR 2.30; 95%CI 1.23–4.30).
Conclusions
Admission to the ICU in off-hours is independently associated to patient mortality, which is also higher in patients admitted on weekends and non-working days compared to the daily night shifts.