Time of admission to intensive care unit, strained capacity, and mortality: A retrospective cohort study.
J Crit Care
; 54: 1-6, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-31306832
ABSTRACT
PURPOSE:
We sought to study the association between afterhours ICU admission and ICU mortality considering measures of strained ICU capacity. MATERIALS ANDMETHODS:
Retrospective analysis of 4141 admissions to 2 ICUs in Lisbon, Portugal (06/2016-06/2018). Primary exposure was ICU admission on 2000â¯h-0759â¯h. Primary outcome was ICU mortality. Measures of strained ICU capacity were bed occupancy rate ≥â¯90% and cluster of ICU admissions 2â¯h before or following index admission.RESULTS:
There were 1581 (38.2%) afterhours ICU admissions. Median APACHE II score (19 vs. 20) was similar between patients admitted afterhours and others (Pâ¯=â¯.27). Patients admitted afterhours had higher crude ICU mortality (15.4% vs. 21.9%; Pâ¯<â¯.001), but similar adjusted ICU mortality (aOR [95%CI]â¯=â¯1.15 [0.97-1.38]; Pâ¯=â¯.12). While bed occupancy rateâ¯≥â¯90% was more frequent in patients admitted afterhours (23.1% vs. 29.1%) or deceased in ICU (23.6% vs. 33.7%), cluster of ICU admissions was more frequent in patients admitted during daytime hours (75.2% vs. 58.9%) or that survived the ICU stay (70.1% vs. 63.9%; Pâ¯≤â¯.001 for all). These measures of strained ICU capacity were not associated with adjusted ICU mortality (Pâ¯≥â¯.10 for both).CONCLUSIONS:
Afterhours ICU admission and measures of strained ICU capacity were associated with crude but not adjusted ICU mortality.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mortalidade Hospitalar
/
Cuidados Críticos
/
Hospitalização
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article