Time of Day and its Association with Risk of Death and Chance of Discharge in Critically Ill Patients: a Retrospective Study

Detalhes bibliográficos
Autor(a) principal: Zajic, P
Data de Publicação: 2019
Outros Autores: Bauer, P, Rhodes, A, Moreno, R, Fellinger, T, Metnitz, B, Posch, M, Metnitz, P
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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spelling 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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