Article (Scientific journals)
Mortality associated with timing of admission to and discharge from ICU: a retrospective cohort study.
Laupland, Kevin B.; Misset, Benoît; Souweine, Bertrand et al.
2011In BMC Health Services Research, 11, p. 321
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Keywords :
Adult; After-Hours Care; Aged; Cohort Studies; Female; France/epidemiology; Humans; Intensive Care Units/statistics & numerical data; Male; Middle Aged; Mortality/trends; Patient Admission; Patient Discharge; Risk Assessment; Time Factors
Abstract :
[en] BACKGROUND: Although the association between mortality and admission to intensive care units (ICU) in the "after hours" (weekends and nights) has been the topic of extensive investigation, the timing of discharge from ICU and outcome has been less well investigated. The objective of this study was to assess effect of timing of admission to and discharge from ICUs and subsequent risk for death. METHODS: Adults (>/= 18 years) admitted to French ICUs participating in Outcomerea between January 2006 and November 2010 were included. RESULTS: Among the 7,380 patients included, 61% (4,481) were male, the median age was 62 (IQR, 49-75) years, and the median SAPS II score was 40 (IQR, 28-56). Admissions to ICU occurred during weekends (Saturday and Sunday) in 1,708 (23%) cases, during the night (18:00-07:59) in 3,855 (52%), and on nights and/or weekends in 4,659 (63%) cases. Among 5,992 survivors to ICU discharge, 903 (15%) were discharged on weekends, 659 (11%) at night, and 1,434 (24%) on nights and/or weekends. After controlling for a number of co-variates using logistic regression analysis, admission during the after hours was not associated with an increased risk for death. However, patients discharged from ICU on nights were at higher adjusted risk (odds ratio, 1.54; 95% confidence interval, 1.12-2.11) for death. CONCLUSIONS: In this study, ICU discharge at night but not admission was associated with a significant increased risk for death. Further studies are needed to examine whether minimizing night time discharges from ICU may improve outcome.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Laupland, Kevin B.
Misset, Benoît ;  Centre Hospitalier Universitaire de Liège - CHU > Service de Soins Intensifs
Souweine, Bertrand
Tabah, Alexis
Azoulay, Elie
Goldgran-Toledano, Dany
Dumenil, Anne-Sylvie
Vesin, Aurelien
Jamali, Samir
Kallel, Hatem
Clec'h, Christophe
Darmon, Michael
Schwebel, Carole
Timsit, Jean-Francois
More authors (4 more) Less
Language :
English
Title :
Mortality associated with timing of admission to and discharge from ICU: a retrospective cohort study.
Publication date :
2011
Journal title :
BMC Health Services Research
eISSN :
1472-6963
Publisher :
BioMed Central, London, United Kingdom
Volume :
11
Pages :
321
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 21 February 2020

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