Hora da admissão na unidade de emergência e mortalidade hospitalar na síndrome coronária aguda

Abstract

Background: The relationship between admission time to an emergency service and in-hospital outcomes in acute coronary syndrome (ACS) is controversial. Admission during off-hours would be associated with worse prognosis.

Night admission is an independent risk factor for mortality in trauma patients - a systemic error approach

“…Another factor that may have important association is related to the fatigue of professionals at night, and these are often the same professionals who worked during the day and stay at night, or who may already have come from other working hours; furthermore, the inversion of sleep-wake cycle can change and attention influence the procedures adopted 3,[17][18][19][20] . This study, performed in a major hospital in the emergency area, is consistent with data in the literature regarding the morbidity and mortality of patients admitted in different shifts and in the middle or end of the week, showing a higher mortality in patients admitted in the "off- Table 2 -Table 2 -Table 2 -Table 2 -Table 2 8,9,21 . It was shown that there was a higher mortality in trauma patients, who underwent surgery, admitted at night, and on weekends.…”

“…The cumulative presence of a number of unfavorable conditions is remarkable and very common in these periods, situations that favor and increase vulnerability to error [1][2][3][4][5][6][7][8][9][10] . Specific studies in patients with acute myocardial infarction, ischemic stroke and the Intensive Care Units showed higher rate of clinical complications and hospital mortality in the "off-hours" periods (nighttime or weekends) [4][5][6][7][8][9][10][11][12] . The volume of evidence demonstrating higher incidence of unfavorable outcomes in these adverse conditions weakens the idea of occasional errors as the cause of these events [4][5][6][7][8][9][10] .…”

“…Specific studies in patients with acute myocardial infarction, ischemic stroke and the Intensive Care Units showed higher rate of clinical complications and hospital mortality in the "off-hours" periods (nighttime or weekends) [4][5][6][7][8][9][10][11][12] . The volume of evidence demonstrating higher incidence of unfavorable outcomes in these adverse conditions weakens the idea of occasional errors as the cause of these events [4][5][6][7][8][9][10] . This highlights the need to analyze these situations trough of a model to interpret the error with a systemic view.…”

“…The volume of evidence demonstrating higher incidence of unfavorable outcomes in these adverse conditions weakens the idea of occasional errors as the cause of these events [4][5][6][7][8][9][10] . This highlights the need to analyze these situations trough of a model to interpret the error with a systemic view.…”