Cargando…
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...
Autores principales: | , , , , , |
---|---|
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 |
_version_ | 1782187751154647040 |
---|---|
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. |
format | Text |
id | pubmed-2952107 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT peetersbabette offhoursadmissionandmortalityintwopediatricintensivecareunitswithout24hinhouseseniorstaffattendance AT jansennicolaasjg offhoursadmissionandmortalityintwopediatricintensivecareunitswithout24hinhouseseniorstaffattendance AT bollencasperw offhoursadmissionandmortalityintwopediatricintensivecareunitswithout24hinhouseseniorstaffattendance AT vanvughtadrianusj offhoursadmissionandmortalityintwopediatricintensivecareunitswithout24hinhouseseniorstaffattendance AT vanderheidedouwe offhoursadmissionandmortalityintwopediatricintensivecareunitswithout24hinhouseseniorstaffattendance AT albersmarceljij offhoursadmissionandmortalityintwopediatricintensivecareunitswithout24hinhouseseniorstaffattendance |