Hospital mortality among adults admitted to and discharged from intensive care on weekends and evenings

Laupland, Kevin B.; Shahpori, Reza; Kirkpatrick, Andrew W.; Stelfox, Henry T.

doi:10.1016/j.jcrc.2007.09.001

Cited by 145 publications

(129 citation statements)

References 22 publications

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120

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“…These patients are more likely to have had prior limited physiological reserve, or to have sustained substantial loss of physical capacity during their ICU stay, and therefore to be at higher risk following discharge. The odds ratio for mortality was 1.34 which is very similar to previous studies in Australia: 1.7 [2], 1.63 [3]; in Australia and New Zealand: 1.4 [4]; in the UK: 1.46 [5]; in Canada: 1.22 [6], 1.2 [7]; and in France: 1.56 [8]. The consistency of the impact of night discharge on outcome is remarkable since it is observed across countries with different healthcare systems and funding.…”

supporting

confidence: 87%

Night thoughts

Guidet

Bion

2014

Intensive Care Med

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supporting

confidence: 87%

Night thoughts

Guidet

Bion

2014

Intensive Care Med

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“…11 Worse outcomes have been reported for patients admitted outside normal working hours with myocardial infarction 12 and in 'night-time' (6 pm-8 am) admissions to some intensive care units. 13 Unexpected deaths were found to be more common among night-time emergency medical admissions in a UK pilot study of quality of care issues. 14 We explored this variation in mortality for emergency medical admissions further, by investigating whether individual day of the week of admission was related to outcome, and whether admission at night or during any out-of-hours period, as well as at the weekend, was associated with an increased mortality.…”

Section: Introductionmentioning

confidence: 99%

Mortality in out-of-hours emergency medical admissions – more than just a weekend effect

Maggs¹,

Mallet²

2010

JRCPE

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Mortality among emergency medical admissions to hospital is higher for admissions at the weekend than on weekdays; this also holds true for certain specific conditions. However, it is unknown whether that effect is limited to weekends. This study calculated mortality in emergency medical admissions for each day of the week, and compared mortality at weekends with weekdays, at nights with days, and in all out-of-hours periods with in-hours in a UK district general hospital. Total mortality was increased for admissions on Mondays, at night, and in all out-of-hours periods; late in-hospital mortality (after seven days) remained increased when the initial admission occurred on Mondays, at night or out of hours. It is likely that illness severity as well as resource and organisational factors are involved.

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“…In the present study, night time admissions were associated with significantly higher mortality. A multicenter retrospective study carried out in Canada during 2008 by Laupland KB et al [4] has shown increased mortality for patients admitted to intensive care unit at night compared to those admitted during the day but without increasing mortality during the weekends. The study by Luyt CE et al [5], conducted in 23 ICUs in England, Wales and Northern Ireland over 3 years in 2007, did not show a significant difference in the mortality for patients admitted during off hours when compared to those admitted during the day time to intensive care unit.…”

Section: Discussionmentioning

confidence: 99%