Increased mortality associated with after-hours and weekend admission to ICU

January 01, 0001

Increased mortality associated with after-hours and weekend admission to ICU

The aim of this retrospective cohort analysis using the Australian and New Zealand Intensive Care Society Adult Patient Database, involving 245 057 admissions to 41 Australian ICUs from January 2000 to December 2008, was to study variation in mortality associated with time and day of admission to the intensive care unit (ICU).

48% of patients were admitted after hours (18:00-05:59) and 20% of patients were admitted on weekends (Saturday and Sunday). Patients admitted after hours had a 17% hospital mortality rate compared with 14% of patients admitted in hours; and standardised mortality ratio (SMRs) of 0.92 and 0.83, respectively. Weekend admissions had a 20% hospital mortality rate compared with 14% on weekdays, with SMRs of 0.95 and 0.92, respectively. Variation in outcome with time of admission to ICU was accounted for predominantly by elective surgical patients.

The researchers concluded: "Patients admitted to ICUs in Australia after hours and on weekends have a higher observed and risk-adjusted mortality than patients admitted at other times. Further research is required to determine the causes and relationship to resource availability and staffing."

There are many confounders, but rostering and pay need to be considered.


For the full abstract, click here.

MJA 194(6):287-292, 21 March 2011 © The Medical Journal of Australia 2011
Increased mortality associated with after-hours and weekend admission to the intensive care unit: a retrospective analysis. Deepak Bhonagiri, David V Pilcher and Michael J Bailey. Correspondence to Deepak Bhonagiri: [email protected]

Category: HSR. Health Services Research. Keywords: mortality, after hours, weekend, admission, intensive care, retrospective analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 8 March 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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