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Off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance

PURPOSE: To compare risk-adjusted mortality of children non-electively admitted during off-hours with risk-adjusted mortality of children admitted during office hours to two pediatric intensive care units (PICUs) without 24-h in-house attendance of senior staff. DESIGN: Prospective observational stu...

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Autores principales: Peeters, Babette, Jansen, Nicolaas J. G., Bollen, Casper W., van Vught, Adrianus J., van der Heide, Douwe, Albers, Marcel J. I. J.
Formato: Texto
Lenguaje:English
Publicado: Springer-Verlag 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952107/
https://www.ncbi.nlm.nih.gov/pubmed/20721531
http://dx.doi.org/10.1007/s00134-010-2020-4
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author Peeters, Babette
Jansen, Nicolaas J. G.
Bollen, Casper W.
van Vught, Adrianus J.
van der Heide, Douwe
Albers, Marcel J. I. J.
author_facet Peeters, Babette
Jansen, Nicolaas J. G.
Bollen, Casper W.
van Vught, Adrianus J.
van der Heide, Douwe
Albers, Marcel J. I. J.
author_sort Peeters, Babette
collection PubMed
description PURPOSE: To compare risk-adjusted mortality of children non-electively admitted during off-hours with risk-adjusted mortality of children admitted during office hours to two pediatric intensive care units (PICUs) without 24-h in-house attendance of senior staff. DESIGN: Prospective observational study, performed between January 2003 and December 2007, in two PICUs without 24-h in-house attendance of senior staff, located in tertiary referral children’s hospitals in the Netherlands. METHODS: Standardized mortality rates (SMRs) of patients admitted during off-hours were compared to SMRs of patients admitted during office hours using Pediatric Index of Mortality (PIM1) and Pediatric Risk of Mortality (PRISM2) scores. Office hours were defined as week days between 8:00 a.m. and 6:00 p.m., with in-house attendance of senior staff, and off-hours as week days between 6:00 p.m. and 8:00 a.m., Saturdays, Sundays and public holidays, with one resident covering the PICU and senior staff directly available on-call. RESULTS: Of 3,212 non-elective patients admitted to the PICUs, 2,122 (66%) were admitted during off-hours. SMRs calculated according to PIM1 and PRISM2 did not show a significant difference with those of patients admitted during office hours. There was no significant effect of admission time on mortality in multivariate logistic regression with odds ratios of death in off-hours of 0.95 (PIM1, 95% CI 0.71–1.27, p = 0.73) and 1.03 (PRISM2, 95% CI 0.76–1.39, p = 0.82). CONCLUSION: Off-hours admission to our PICUs without 24-h in-house attendance of senior staff was not associated with higher SMRs than admission during office hours when senior staff were available in-house.
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spelling pubmed-29521072010-10-21 Off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance Peeters, Babette Jansen, Nicolaas J. G. Bollen, Casper W. van Vught, Adrianus J. van der Heide, Douwe Albers, Marcel J. I. J. Intensive Care Med Pediatric Original PURPOSE: To compare risk-adjusted mortality of children non-electively admitted during off-hours with risk-adjusted mortality of children admitted during office hours to two pediatric intensive care units (PICUs) without 24-h in-house attendance of senior staff. DESIGN: Prospective observational study, performed between January 2003 and December 2007, in two PICUs without 24-h in-house attendance of senior staff, located in tertiary referral children’s hospitals in the Netherlands. METHODS: Standardized mortality rates (SMRs) of patients admitted during off-hours were compared to SMRs of patients admitted during office hours using Pediatric Index of Mortality (PIM1) and Pediatric Risk of Mortality (PRISM2) scores. Office hours were defined as week days between 8:00 a.m. and 6:00 p.m., with in-house attendance of senior staff, and off-hours as week days between 6:00 p.m. and 8:00 a.m., Saturdays, Sundays and public holidays, with one resident covering the PICU and senior staff directly available on-call. RESULTS: Of 3,212 non-elective patients admitted to the PICUs, 2,122 (66%) were admitted during off-hours. SMRs calculated according to PIM1 and PRISM2 did not show a significant difference with those of patients admitted during office hours. There was no significant effect of admission time on mortality in multivariate logistic regression with odds ratios of death in off-hours of 0.95 (PIM1, 95% CI 0.71–1.27, p = 0.73) and 1.03 (PRISM2, 95% CI 0.76–1.39, p = 0.82). CONCLUSION: Off-hours admission to our PICUs without 24-h in-house attendance of senior staff was not associated with higher SMRs than admission during office hours when senior staff were available in-house. Springer-Verlag 2010-08-19 2010 /pmc/articles/PMC2952107/ /pubmed/20721531 http://dx.doi.org/10.1007/s00134-010-2020-4 Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Pediatric Original
Peeters, Babette
Jansen, Nicolaas J. G.
Bollen, Casper W.
van Vught, Adrianus J.
van der Heide, Douwe
Albers, Marcel J. I. J.
Off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance
title Off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance
title_full Off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance
title_fullStr Off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance
title_full_unstemmed Off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance
title_short Off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance
title_sort off-hours admission and mortality in two pediatric intensive care units without 24-h in-house senior staff attendance
topic Pediatric Original
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2952107/
https://www.ncbi.nlm.nih.gov/pubmed/20721531
http://dx.doi.org/10.1007/s00134-010-2020-4
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