Cargando…

Effect of admission time on mortality in an intensive care unit in Mainland China: a propensity score matching analysis

INTRODUCTION: The relationship between admission time and intensive care unit (ICU) mortality is inconclusive and influenced by various factors. This study aims to estimate the effect of admission time on ICU outcomes in a tertiary teaching hospital in China by propensity score matching (PSM) and st...

Descripción completa

Detalles Bibliográficos
Autores principales: Ju, Min-Jie, Tu, Guo-Wei, Han, Yan, He, Hong-Yu, He, Yi-Zhou, Mao, Hai-Lei, Wu, Zhao-Guang, Yin, Yi-Qing, Luo, Jian-Feng, Zhu, Du-Ming, Luo, Zhe, Xue, Zhang-Gang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055975/
https://www.ncbi.nlm.nih.gov/pubmed/24112558
http://dx.doi.org/10.1186/cc13053
_version_ 1782320758607839232
author Ju, Min-Jie
Tu, Guo-Wei
Han, Yan
He, Hong-Yu
He, Yi-Zhou
Mao, Hai-Lei
Wu, Zhao-Guang
Yin, Yi-Qing
Luo, Jian-Feng
Zhu, Du-Ming
Luo, Zhe
Xue, Zhang-Gang
author_facet Ju, Min-Jie
Tu, Guo-Wei
Han, Yan
He, Hong-Yu
He, Yi-Zhou
Mao, Hai-Lei
Wu, Zhao-Guang
Yin, Yi-Qing
Luo, Jian-Feng
Zhu, Du-Ming
Luo, Zhe
Xue, Zhang-Gang
author_sort Ju, Min-Jie
collection PubMed
description INTRODUCTION: The relationship between admission time and intensive care unit (ICU) mortality is inconclusive and influenced by various factors. This study aims to estimate the effect of admission time on ICU outcomes in a tertiary teaching hospital in China by propensity score matching (PSM) and stratified analysis. METHODS: A total of 2,891 consecutive patients were enrolled in this study from 1 January 2009 to 29 December 2011. Multivariate logistic regression and survival analysis were performed in this retrospective study. PSM and stratified analysis were applied for confounding factors, such as Acute Physiology and Chronic Health Evaluation II (APACHE II) score and admission types. RESULTS: Compared with office hour subgroup (n = 2,716), nighttime (NT, n = 175) subgroup had higher APACHE II scores (14 vs. 8, P < 0.001), prolonged length of stay in the ICU (42 vs. 24 h, P = 0.011), and higher percentages of medical (8.6% vs. 3.3%, P < 0.001) and emergency (59.4% vs. 12.2%, P < 0.001) patients. Moreover, NT admissions were related to higher ICU mortality [odds ratio (OR), 1.725 (95% CI 1.118–2.744), P = 0.01] and elevated mortality risk at 28 days [14.3% vs. 3.2%; OR, 1.920 (95% CI 1.171–3.150), P = 0.01]. PSM showed that admission time remained related to ICU outcome (P = 0.045) and mortality risk at 28 days [OR, 2.187 (95% CI 1.119–4.271), P = 0.022]. However, no mortality difference was found between weekend and workday admissions (P = 0.849), even if weekend admissions were more related to higher APACHE II scores compared with workday admissions. CONCLUSIONS: NT admission was associated with poor ICU outcomes. This finding may be related to shortage of onsite intensivists and qualified residents during NT. The current staffing model and training system should be improved in the future.
format Online
Article
Text
id pubmed-4055975
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-40559752014-06-13 Effect of admission time on mortality in an intensive care unit in Mainland China: a propensity score matching analysis Ju, Min-Jie Tu, Guo-Wei Han, Yan He, Hong-Yu He, Yi-Zhou Mao, Hai-Lei Wu, Zhao-Guang Yin, Yi-Qing Luo, Jian-Feng Zhu, Du-Ming Luo, Zhe Xue, Zhang-Gang Crit Care Research INTRODUCTION: The relationship between admission time and intensive care unit (ICU) mortality is inconclusive and influenced by various factors. This study aims to estimate the effect of admission time on ICU outcomes in a tertiary teaching hospital in China by propensity score matching (PSM) and stratified analysis. METHODS: A total of 2,891 consecutive patients were enrolled in this study from 1 January 2009 to 29 December 2011. Multivariate logistic regression and survival analysis were performed in this retrospective study. PSM and stratified analysis were applied for confounding factors, such as Acute Physiology and Chronic Health Evaluation II (APACHE II) score and admission types. RESULTS: Compared with office hour subgroup (n = 2,716), nighttime (NT, n = 175) subgroup had higher APACHE II scores (14 vs. 8, P < 0.001), prolonged length of stay in the ICU (42 vs. 24 h, P = 0.011), and higher percentages of medical (8.6% vs. 3.3%, P < 0.001) and emergency (59.4% vs. 12.2%, P < 0.001) patients. Moreover, NT admissions were related to higher ICU mortality [odds ratio (OR), 1.725 (95% CI 1.118–2.744), P = 0.01] and elevated mortality risk at 28 days [14.3% vs. 3.2%; OR, 1.920 (95% CI 1.171–3.150), P = 0.01]. PSM showed that admission time remained related to ICU outcome (P = 0.045) and mortality risk at 28 days [OR, 2.187 (95% CI 1.119–4.271), P = 0.022]. However, no mortality difference was found between weekend and workday admissions (P = 0.849), even if weekend admissions were more related to higher APACHE II scores compared with workday admissions. CONCLUSIONS: NT admission was associated with poor ICU outcomes. This finding may be related to shortage of onsite intensivists and qualified residents during NT. The current staffing model and training system should be improved in the future. BioMed Central 2013 2013-10-10 /pmc/articles/PMC4055975/ /pubmed/24112558 http://dx.doi.org/10.1186/cc13053 Text en Copyright © 2013 Ju et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Ju, Min-Jie
Tu, Guo-Wei
Han, Yan
He, Hong-Yu
He, Yi-Zhou
Mao, Hai-Lei
Wu, Zhao-Guang
Yin, Yi-Qing
Luo, Jian-Feng
Zhu, Du-Ming
Luo, Zhe
Xue, Zhang-Gang
Effect of admission time on mortality in an intensive care unit in Mainland China: a propensity score matching analysis
title Effect of admission time on mortality in an intensive care unit in Mainland China: a propensity score matching analysis
title_full Effect of admission time on mortality in an intensive care unit in Mainland China: a propensity score matching analysis
title_fullStr Effect of admission time on mortality in an intensive care unit in Mainland China: a propensity score matching analysis
title_full_unstemmed Effect of admission time on mortality in an intensive care unit in Mainland China: a propensity score matching analysis
title_short Effect of admission time on mortality in an intensive care unit in Mainland China: a propensity score matching analysis
title_sort effect of admission time on mortality in an intensive care unit in mainland china: a propensity score matching analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4055975/
https://www.ncbi.nlm.nih.gov/pubmed/24112558
http://dx.doi.org/10.1186/cc13053
work_keys_str_mv AT juminjie effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT tuguowei effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT hanyan effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT hehongyu effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT heyizhou effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT maohailei effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT wuzhaoguang effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT yinyiqing effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT luojianfeng effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT zhuduming effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT luozhe effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis
AT xuezhanggang effectofadmissiontimeonmortalityinanintensivecareunitinmainlandchinaapropensityscorematchinganalysis