Effect of Admission and Discharge Times on Hospital Mortality in Patients With Sepsis

Zhou, Xiaoming; Weng, Jie; Xu, Zhe; Yang, Jinweng; Lin, Jingjing; Hou, Ruonan; Zhou, Zhiliang; Wang, Liang; Wang, Zhiyi; Chen, Chan

doi:10.1097/ccm.0000000000005767

Cited by 3 publications

(6 citation statements)

References 32 publications

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“…The 22 studies which were selected for full-text analysis underwent detailed examination and nine were found to be appropriate based on the inclusion criteria. [14][15][16][19][20][21][22][23][24] The remaining 13 studies were excluded for reasons mentioned in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…A recent study from Brazil has shown that a reduced nurse-to-patient ratio, absence of checklists, and fewer standardized protocols during weekends may partly explain a higher risk of ICU mortality on weekends. 32 Zhou et al 15 have also shown that while no weekend effect was not on mortality rates of sepsis patients, the patient-to-nurse ratio was an independent predictor of outcomes. Secondly, it has been postulated that patients reporting on weekends are often sicker.…”

Section: Discussionmentioning

confidence: 96%

“…Immediate availability of diagnostic equipment may also be affected on weekends. 7 In the past decade, several studies [14][15][16] have reported data on the "weekend" effect for sepsis and septic shock patients, however, results have been variable. To overcome this, there is a need for a comprehensive meta-analysis that pools data from such studies and provides high-quality evidence to practicing clinicians.…”

Section: Introductionmentioning

confidence: 99%

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RETRACTED: Effect of weekend admission on mortality risk in patients with sepsis and septic shock: A systematic review and meta-analysis

Xiong,

Shi

2023

Scott Med J

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Background There is an ongoing debate if weekend admissions of critically ill patients are associated with higher mortality rates. The current review aimed to specifically assess this effect in sepsis and septic shock patients by comparing mortality rates with weekend versus weekday admissions. Methods PubMed, CENTRAL, Scopus, Web of Science, and Embase were searched up to 20th February 2023 with an additional search of Google Scholar for gray literature. Results Nine studies were eligible. Meta-analysis of all nine studies with data from 1,134,417 patients demonstrated that sepsis or septic shock patients admitted on weekends don’t have higher mortality as compared to those admitted on weekdays (OR: 1.04; 95% CI: 1.00, 1.09; p = 0.05; I2 = 93%). On subgroup analysis based on sample size (>2000 or <2000 patients) and timing of mortality, we noted no difference in the significance of the results. However, there was a small significant increased risk of mortality with weekend admission noted in studies on the Asian population and including septic shock patients. Conclusion Weekend admission does not have an adverse impact on mortality rates of sepsis and septic shock patients. Results must be interpreted with caution owing to high interstudy heterogeneity and variation in confounders adjusted by individual studies.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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RETRACTED: Effect of weekend admission on mortality risk in patients with sepsis and septic shock: A systematic review and meta-analysis

Xiong,

Shi

2023

Scott Med J

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“…In a study conducted in the UK no influence of week and time of admission on mortality could be found. 8 Similarly, ICU admission time and weekend admission were not independent risk factors of hospital mortality in critically ill patients with sepsis in a study done by Zhou et al 19 …”

Section: Discussionmentioning

confidence: 90%

Effect of Admission Day and Time on Patient Outcome: An Observational Study in Intensive Care Units of a Tertiary Care Hospital in India

Bhattacharyya,

Todi

2024

Indian Journal of Critical Care Medicine

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Background The current study aimed to assess any association between intensive care unit (ICU) and hospital outcomes with ICU admission timings of critically ill patients. Methods Retrospective observational single-center study involving all adult admissions. Each patient admission was categorized in “after-hours” (08:00 p.m.–07:59 a.m.), or “normal-hours” (08:00 a.m.–07:59 p.m.), “Weekday” (Monday–Saturday), or “Weekend” (Sunday), “Same day” (admission directly to ICU) or “other day admission” (admission to ICU after a hospital stay of ≥24 hours). Intensive care unit and hospital mortality, length of stay (LOS), and ICU readmission were assessed for any association with different admission timings. Results Among 3,029 patients, 54.2% (1,668) were male, with mean age 66.49 (SD ± 15.69) years, mean acute physiology and chronic health evaluation-IV (APACHE-IV) score 55.5 (SD ± 26.3). Around 86.1% of admission occurred during weekdays, 13.9% on weekends, 57.4% normal-hours, 42.6% after-hours, 66.3% same day and 33.7% other day admission. Intensive care unit and hospital mortality were 10.8 and 14.2% respectively. Neither ICU nor hospital mortality were significantly different among patients admitted normal vs after-hours ( p = 0.32, 0.23), and weekdays vs weekends ( p = 0.09, 0.93), nor was ICU LOS ( p = 0.21, 0.74). Intensive care unit and hospital mortality ( p = 0.001), DORB ( p = 0.001), hospital LOS ( p = 0.001), and readmission to ICU ( p = 0.001) were significantly higher in the other day admission group compared to same-day admission. In a multivariate regression analysis age, APACHE IV score along with other day admission to ICU did have a significant effect on both ICU and hospital mortality. Conclusion Intensive care unit and hospital mortality and LOS did not differ significantly with hours or days of ICU admission though they were significantly higher in other day admission groups. How to cite this article Bhattacharyya M, Todi SK. Effect of Admission Day and Time on Patient Outcome: An Observational Study in Intensive Care Units of a Tertiary Care Hospital in India. Indian J Crit Care Med 2024;28(5):436–441.

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“…In China, some studies have explored the weekend effect on acute myocardial infarction ( 18 ), subarachnoid hemorrhage ( 19 ), and sepsis patients ( 20 ). A longer hospital length of stay was observed among stroke patients with weekend admissions in a Taiwanese study ( 21 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of weekend versus weekday admission on the mortality of acute ischemic stroke patients in China: an analysis of data from the Chinese acute ischemic stroke treatment outcome registry

Huang

Sun

et al. 2023

Front. Neurol.

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BackgroundDue to disparities in medical resources in rural and urban areas as well as in different geographic regions in China, the effect of weekend versus weekday admission on the outcomes of acute ischemic stroke (AIS) patients is unknown. Our aim was to investigate whether the outcomes of AIS patients differ according to the day of admission in China.MethodsThe data were extracted from the Chinese Acute Ischemic Stroke Treatment Outcome Registry (CASTOR), a multicenter prospective study database of patients diagnosed with AIS. The chi-square test (χ2) and logistic regression were used to assess mortality for weekday and weekend admissions among AIS patients stratified by rural or urban status and geographic region (including the eastern, northeastern, central, and western regions).ResultsIn total, 9,256 patients were included in this study. Of these patients, 57.2% were classified as urban, and 42.8% were classified as rural. A total of 6,760 (73%) patients were admitted on weekdays, and 2,496 (27%) were admitted on weekends. There was no significant difference in the mortality rate among patients admitted on weekends compared with those admitted on weekdays in urban (7.5% versus 7.4%) or rural areas (8.8% versus 8.1%; p > 0.05). The mortality rate was the highest among patients admitted on weekends and weekdays (11.6% versus 10.3%) in the northeastern area, without statistical significance before and after adjusting for the patients’ background characteristics (p > 0.05). In addition, regression analysis revealed that the mortality of patients admitted on weekdays was more likely to be influenced by regional subgroup, hospital level and intravenous thrombolysis than that of patients admitted on weekends.ConclusionThe weekend effect was not observed in the mortality of patients with AIS regardless of rural–urban status or geographic region in China.

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Effect of Admission and Discharge Times on Hospital Mortality in Patients With Sepsis

Cited by 3 publications

References 32 publications

RETRACTED: Effect of weekend admission on mortality risk in patients with sepsis and septic shock: A systematic review and meta-analysis

RETRACTED: Effect of weekend admission on mortality risk in patients with sepsis and septic shock: A systematic review and meta-analysis

Effect of Admission Day and Time on Patient Outcome: An Observational Study in Intensive Care Units of a Tertiary Care Hospital in India

Effect of weekend versus weekday admission on the mortality of acute ischemic stroke patients in China: an analysis of data from the Chinese acute ischemic stroke treatment outcome registry

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