ABSTRACT
Objectives: The objective of this study was to assess the effect of the timing of intensive care unit (ICU) admissions (“off hours” or “business hours”) on patients’ subsequent risk of death.
Methods: This study was conducted at the Dr. Lutfi Kirdar Kartal Training and Research Hospital in Turkey. We retrospectively analyzed the mortality rates of 1605 patients treated between January 2007 and December 2010 according to their ICU admission times and outcomes (discharged from or died in the ICU). All patients admitted to one of the hospital’s ICUs during this four-year period were evaluated, with no exclusion criteria applied. The primary outcome measures included the time of admission and the discharge and mortality rates. In this study, “business hours” referred to 8:00-16:59 on weekdays, whereas “off hours” referred to 17:00-07:59 on weekdays and weekends (from 00:00 Saturday to 23:59 Sunday).
Results: Mortality rates were significantly lower among the patients admitted on Mondays and Wednesdays compared to the other patients (p=0.037 and p=0.045, respectively). Among the patients admitted to the ICU on Saturdays, the mortality rate was higher than the discharge rate (p=0.004). The risk of death was higher for the patients admitted on weekends compared to the patients admitted on weekdays (p=0.005). In this study, a significant relationship between time of admission and mortality was observed.
Conclusions: Our study suggests that patients admitted to the ICU over the weekend and during “off hours” have a higher mortality risk compared to patients admitted on weekdays during “business hours”.
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