Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective Study
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/5023 |
Resumo: | Outcomes following admission to intensive care units (ICU) may vary with time and day. This study investigated associations between time of day and risk of ICU mortality and chance of ICU discharge in acute ICU admissions. Adult patients (age ≥ 18 years) who were admitted to ICUs participating in the Austrian intensive care database due to medical or surgical urgencies and emergencies between January 2012 and December 2016 were included in this retrospective study. Readmissions were excluded. Statistical analysis was conducted using the Fine-and-Gray proportional subdistribution hazards model concerning ICU mortality and ICU discharge within 30 days adjusted for SAPS 3 score. 110,628 admissions were analysed. ICU admission during late night and early morning was associated with increased hazards for ICU mortality; HR: 1.17; 95% CI: 1.08-1.28 for 00:00-03:59, HR: 1.16; 95% CI: 1.05-1.29 for 04:00-07:59. Risk of death in the ICU decreased over the day; lowest HR: 0.475, 95% CI: 0.432-0.522 for 00:00-03:59. Hazards for discharge from the ICU dropped sharply after 16:00; lowest HR: 0.024; 95% CI: 0.019-0.029 for 00:00-03:59. We conclude that there are "time effects" in ICUs. These findings may spark further quality improvement efforts. |
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Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective StudyHSJ UCIAgedFemaleMaleHumansMiddle AgedCritical Illness / mortality*Critical Illness / therapyIntensive Care Units / statistics & numerical dataPatient Discharge / statistics & numerical data*Proportional Hazards ModelsTime FactorsRetrospective StudiesOutcomes following admission to intensive care units (ICU) may vary with time and day. This study investigated associations between time of day and risk of ICU mortality and chance of ICU discharge in acute ICU admissions. Adult patients (age ≥ 18 years) who were admitted to ICUs participating in the Austrian intensive care database due to medical or surgical urgencies and emergencies between January 2012 and December 2016 were included in this retrospective study. Readmissions were excluded. Statistical analysis was conducted using the Fine-and-Gray proportional subdistribution hazards model concerning ICU mortality and ICU discharge within 30 days adjusted for SAPS 3 score. 110,628 admissions were analysed. ICU admission during late night and early morning was associated with increased hazards for ICU mortality; HR: 1.17; 95% CI: 1.08-1.28 for 00:00-03:59, HR: 1.16; 95% CI: 1.05-1.29 for 04:00-07:59. Risk of death in the ICU decreased over the day; lowest HR: 0.475, 95% CI: 0.432-0.522 for 00:00-03:59. Hazards for discharge from the ICU dropped sharply after 16:00; lowest HR: 0.024; 95% CI: 0.019-0.029 for 00:00-03:59. We conclude that there are "time effects" in ICUs. These findings may spark further quality improvement efforts.Nature Publishing GroupRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEZajic, PBauer, PRhodes, AMoreno, RFellinger, TMetnitz, BPosch, MMetnitz, P2024-10-08T15:21:15Z20192019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/5023engSci Rep . 2019 Aug 29;9(1):12533.10.1038/s41598-019-48947-yinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-10-28T10:31:48Zoai:repositorio.chlc.pt:10400.17/5023Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-10-28T10:31:48Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective Study |
title |
Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective Study |
spellingShingle |
Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective Study Zajic, P HSJ UCI Aged Female Male Humans Middle Aged Critical Illness / mortality* Critical Illness / therapy Intensive Care Units / statistics & numerical data Patient Discharge / statistics & numerical data* Proportional Hazards Models Time Factors Retrospective Studies |
title_short |
Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective Study |
title_full |
Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective Study |
title_fullStr |
Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective Study |
title_full_unstemmed |
Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective Study |
title_sort |
Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective Study |
author |
Zajic, P |
author_facet |
Zajic, P Bauer, P Rhodes, A Moreno, R Fellinger, T Metnitz, B Posch, M Metnitz, P |
author_role |
author |
author2 |
Bauer, P Rhodes, A Moreno, R Fellinger, T Metnitz, B Posch, M Metnitz, P |
author2_role |
author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Zajic, P Bauer, P Rhodes, A Moreno, R Fellinger, T Metnitz, B Posch, M Metnitz, P |
dc.subject.por.fl_str_mv |
HSJ UCI Aged Female Male Humans Middle Aged Critical Illness / mortality* Critical Illness / therapy Intensive Care Units / statistics & numerical data Patient Discharge / statistics & numerical data* Proportional Hazards Models Time Factors Retrospective Studies |
topic |
HSJ UCI Aged Female Male Humans Middle Aged Critical Illness / mortality* Critical Illness / therapy Intensive Care Units / statistics & numerical data Patient Discharge / statistics & numerical data* Proportional Hazards Models Time Factors Retrospective Studies |
description |
Outcomes following admission to intensive care units (ICU) may vary with time and day. This study investigated associations between time of day and risk of ICU mortality and chance of ICU discharge in acute ICU admissions. Adult patients (age ≥ 18 years) who were admitted to ICUs participating in the Austrian intensive care database due to medical or surgical urgencies and emergencies between January 2012 and December 2016 were included in this retrospective study. Readmissions were excluded. Statistical analysis was conducted using the Fine-and-Gray proportional subdistribution hazards model concerning ICU mortality and ICU discharge within 30 days adjusted for SAPS 3 score. 110,628 admissions were analysed. ICU admission during late night and early morning was associated with increased hazards for ICU mortality; HR: 1.17; 95% CI: 1.08-1.28 for 00:00-03:59, HR: 1.16; 95% CI: 1.05-1.29 for 04:00-07:59. Risk of death in the ICU decreased over the day; lowest HR: 0.475, 95% CI: 0.432-0.522 for 00:00-03:59. Hazards for discharge from the ICU dropped sharply after 16:00; lowest HR: 0.024; 95% CI: 0.019-0.029 for 00:00-03:59. We conclude that there are "time effects" in ICUs. These findings may spark further quality improvement efforts. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019 2019-01-01T00:00:00Z 2024-10-08T15:21:15Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/5023 |
url |
http://hdl.handle.net/10400.17/5023 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Sci Rep . 2019 Aug 29;9(1):12533. 10.1038/s41598-019-48947-y |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Nature Publishing Group |
publisher.none.fl_str_mv |
Nature Publishing Group |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
mluisa.alvim@gmail.com |
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1817548664235622400 |