Comparison of time of admission to a tertiary paediatric intensive care unit over the last 10 years

International paediatric critical care societies recommend 24/7 in-house consultant cover as an ideal standard, a standard that is not widely adopted at least in the Australasian context where intensivists are off-site but on call out of hours. We undertook this study to assess the association of admission time with mortality outcome in our institution where after-hours intensivist cover is off-site. We completed a retrospective cohort study of non-elective patients admitted to the PICU at Sydney Children’s Hospital (Randwick, Australia) over a ten year period, examining the impact of out of hours admission on standardised mortality. 7030 non-elective patients were admitted to PICU between January 1, 2014 to December 31, 2023. 2595 patients were admitted in-hours and 4435 patients were admitted after-hours. Standardised mortality ratios were 0.92 in-hours versus 0.95 after-hours ( p = 0.317). Time of admission to PICU of non-elective patients when dichotomised to in-hours or after-hours, was not associated with a significant difference in standardised mortality ratio. The increased financial and human cost of 24/7 cover is important to consider especially with the absence of a significant mortality difference with our staffing model.