Timing of Admission to the Surgical Intensive Care Unit is Associated with in-Hospital Mortality
10.17479/jacs.2022.12.1.11
- Author:
Mi Kyoung KIM
1
;
Eun-Joo JUNG
;
Seulkee PARK
;
Im-kyung KIM
Author Information
1. Division of Surgical Critical Care, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
- Publication Type:Original Article
- From:
Journal of Acute Care Surgery
2022;12(1):11-17
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:The relationship between the timing of admission (work-hours or after-hours) to the intensive care unit (ICU) and mortality among surgical ICU (SICU) patients is unclear. This study aimed to investigate whether admission to SICU during after-hours was associated with in-hospital mortality.
Methods:This retrospective cohort study was conducted in a tertiary academic hospital. The data of 571 patients who were admitted to the SICU and whose complete medical records were available were analyzed. Work-hours were defined as 07:00 to 19:00 Monday to Friday, during which the ICU was staffed with intensivists. After-hours were defined as any other time during which the SICU was not staffed with intensivists. The primary outcome measure was in-hospital mortality according to the time of admission (work-hours or after-hours) to the SICU.
Results:A total of 333 patients, were admitted to the SICU during work-hours, and 238 patients after-hours. Unplanned admissions (47.1% vs. 33.3%, p < 0.001), acute physiology and chronic health evaluation II score ≥ 25 (23.9% vs. 11.1%, p < 0.001), the need for ventilator support (34.0% vs. 17.4%, p < 0.001), and the use of vasopressors (50.0% vs. 33.3%, p < 0.001) were significantly higher in the after-hours group compared with the work-hours group. Multivariate analyses revealed that the timing of SICU admission was an independent predictor of in-hospital mortality (odds ratio, 2.526; 95% confidence interval, 1.010–6.320; p = 0.048).
Conclusion:This study showed that admission to the SICU during after-hours was associated with increased in-hospital mortality.
