Effect of the timing of admission upon patient prognosis in the Intensive Care Unit: On-hours versus off-hours.

Autor:	Abella A; Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, España., Hermosa C; Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, España., Enciso V; Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, España., Torrejón I; Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, España., Molina R; Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, España., Díaz M; Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, España., Mozo T; Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, España., Gordo F; Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, España. Electronic address: fgordo5@gmail.com., Salinas I; Servicio de Medicina Intensiva, Hospital Universitario del Henares, Coslada, Madrid, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Medicina intensiva [Med Intensiva] 2016 Jan-Feb; Vol. 40 (1), pp. 26-32. Date of Electronic Publication: 2015 Feb 11.
DOI:	10.1016/j.medin.2014.11.009
Abstrakt:	Objective: To assess the repercussion of the timing of admission to the ICU upon patient prognosis. 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. (Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.)
Databáze:	MEDLINE
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