Key result
ICU admission during off-hours was associated with a significantly higher risk of mortality compared to admission during business hours (OR 6.033).
Why the study?
Numerous factors affect intensive care unit admission and discharge decisions, but the effect of admission timing on subsequent patient mortality needed evaluation.
Does ICU admission during off-hours increase mortality in critically ill patients?
Cohort (n=1,605)
No
Does ICU admission during off-hours increase mortality in critically ill patients?
Odds Ratio: 6.033 (95% CI 4.815–7.56)
Absolute Event Rate: 67.8% vs 25.8%
p-value: p=0.001
ICU admission during off-hours and weekends is associated with a significantly higher risk of mortality compared to business hours, highlighting potential disparities in care quality or staffing.
May warrant off-hours ICU staffing review; leaves open causality and need for prospective confirmation.
In recent years, there have been notable advancements in the critical care, including significant progress in medical knowledge, technological innovations, and the development of clinical expertise crucial for effectively treating patients. Numerous factors play a role in shaping the admission and discharge decisions made in the context of intensive care units. In this research we aimed to evaluate the effect of the time of the intensive care unit admissions, categorized as either "off hours" or "business hours," on the subsequent death rates among patients. We performed a retrospective investigation of the mortality rates of 1605 patients in intensive care unit between 2007 and 2010. We included all admissions to the intensive care unit without applying any exclusion criteria. The primary outcome measures in our study were the timing of admission, as well as the rates of discharge and mortality. "Business hours" denoted the time frame from 8:00 to 16:59 on weekdays, while "off hours" encompassed the period from 17:00 to 07:59 on weekdays and throughout the weekends. Significantly reduced mortality rates were evident among patients admitted on Mondays and Wednesdays in comparison to those admitted on other days (p=0.037 and p=0.045, respectively). Furthermore, the study revealed an elevated risk of mortality for admissions during weekends when compared with those admission on weekdays (p=0.005). The results found that a significant association was present between admission timing and mortality. Patients admitted on weekends and during off-hours exhibit an increased risk of mortality when compared to those admitted on weekdays during business hours.
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Taşargöl et al. (2023) conducted a cohort in Intensive care unit admission (n=1,605). ICU admission during off-hours (weekends and 17:01-7:59 on weekdays) vs. ICU admission during business hours (8:00-17:00 on weekdays) was evaluated on Mortality within the ICU (OR 6.033, 95% CI 4.815-7.560, p=0.001). ICU admission during off-hours was associated with a significantly higher risk of mortality compared to admission during business hours (OR 6.033).
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