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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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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 |
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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 |
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