夜间或周末入院与住院相关患者结局的关联。

The association between night or weekend admission and hospitalization-relevant patient outcomes.

机构信息

Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

出版信息

J Hosp Med. 2011 Jan;6(1):10-4. doi: 10.1002/jhm.833. Epub 2010 Nov 24.

DOI:10.1002/jhm.833

PMID:21241035

Abstract

INTRODUCTION

Nights and weekends represent a potentially high-risk time for hospitalized patients. Data regarding night or weekend admission and its impact on outcomes is limited. We studied the association between night or weekend admission and outcomes.

METHODS

We reviewed 857 admissions to the general medicine services from the emergency department (ED) at our tertiary care hospital for demographic information, time and day of admission, and hospitalization-relevant outcomes (length of stay [LOS], hospital charges, intensive care unit [ICU] transfer during hospitalization, repeat ED visit within 30 days, readmission within 30 days, and poor outcome [ICU transfer, cardiac arrest, or death] within the first 24 hours of admission). Outcomes were compared between groups using univariate and multivariate modeling.

RESULTS

Complete data for analysis were available for 824 patients. A total of 58% of patients were admitted at night and 22% were admitted during the weekend. Patients admitted at night as compared to those admitted during the day had similar a LOS (4.1 vs. 4.3, P = 0.38), hospital charges (25,200 vs. 27,500, P = 0.17), ICU transfer during hospitalization (3% vs. 6%, P = 0.06), 30 day repeat ED visit (22% vs. 20%, P = 0.42), 30 day readmission (20% vs. 17%, P = 0.23), and poor outcomes within 24 hours of admission (1% vs. 2%, P = 0.15). Patients admitted during the weekend as compared to those admitted during the week had lower hospital charges and lower likelihood of an ICU transfer but were otherwise similar.

CONCLUSION

Night or weekend admission was not associated with worse hospitalization-relevant outcomes at our tertiary care hospital.

摘要

简介

住院患者在夜间和周末面临潜在的高风险。有关夜间或周末入院及其对结果的影响的数据有限。我们研究了夜间或周末入院与结果之间的关联。

方法

我们回顾了我院急诊部收治的 857 名普通内科患者的入院信息，包括人口统计学信息、入院时间和日期以及与住院相关的结果（住院时间[LOS]、住院费用、住院期间转入重症监护病房[ICU]、30 天内再次就诊于急诊部、30 天内再入院以及入院 24 小时内发生不良预后[转入 ICU、心脏骤停或死亡]）。使用单变量和多变量模型比较组间的结果。

结果

共 824 名患者可进行完整数据分析。夜间入院的患者占 58%，周末入院的患者占 22%。与白天入院的患者相比，夜间入院的患者 LOS（4.1 天 vs. 4.3 天，P = 0.38）、住院费用（25200 美元 vs. 27500 美元，P = 0.17）、住院期间转入 ICU（3% vs. 6%，P = 0.06）、30 天内再次就诊于急诊部（22% vs. 20%，P = 0.42）、30 天内再入院（20% vs. 17%，P = 0.23）以及入院 24 小时内不良预后（1% vs. 2%，P = 0.15）无显著差异。与一周内入院的患者相比，周末入院的患者住院费用较低，转入 ICU 的可能性较低，但其他方面相似。