医院死亡的昼夜节律：重症监护病房与非重症监护病房的比较。

Circadian rhythm of hospital deaths: comparison between intensive care unit and non-intensive care unit.

作者信息

Rocha Antônio Sérgio Cordeiro da, Araújo Mônica Peres de, Campos Augusta, Costa Filho Rubens, Mesquita Evandro Tinoco, Santos Marcus Vinicius

机构信息

Unidade Clínica, Hospital Pró-Cardíaco, Rio de Janeiro, RJ, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2011 Sep-Oct;57(5):529-33. doi: 10.1590/s0104-42302011000500010.

DOI:10.1590/s0104-42302011000500010

PMID:22012286

Abstract

OBJECTIVE

The demonstration that cardiovascular mortality follows a circadian rhythm led us to verify whether patients dying at the intensive unit care (ICU) and at the non-intensive unit care (non-ICU) follow that rhythm.

METHODS

All hospital's deaths occurring between January 1, 2006 and July 31, 2010 were analyzed. The circadian pattern of the time of death was analyzed in twelve 2 hour intervals. The Chi-square test was used to compare proportions, and Student's t test or ANOVA single factor to compare continuous variables. A p-value < 0.05 was considered statistically significant.

RESULTS

During the study period 700 deaths occurred in the hospital, 211 (30.1%) at the ICU and 88 (12.6%) at the non-ICU. There were more deaths in the first hours of the day, between 6 am and 12 am, at the non-ICU in comparison to the ICU (38% vs. 21%; p = 0.004). In the ICU, we observed that 21% of the deaths occurred between 6 am and 12 pm, 30% between 12 pm and 6 pm, 26% between 6 pm and 12 am and 24% between 12 am and 6 am (p = 0.13), whereas, at the non-ICU, 38% of the deaths occurred between 6 am and 12 pm, 18% between 12 pm and 6 pm, 19% between 6 pm and 12 am and 25% between 12 am and 6 am (p = 0.005).

CONCLUSION

At the non-ICU, deaths occur more often in the morning period and follow a circadian rhythm, which does not occur at the ICU.

摘要

目的

心血管死亡率呈现昼夜节律这一现象促使我们去验证在重症监护病房（ICU）和非重症监护病房（非ICU）死亡的患者是否也遵循这一节律。

方法

对2006年1月1日至2010年7月31日期间该医院发生的所有死亡病例进行分析。将死亡时间的昼夜模式按12个两小时时间段进行分析。采用卡方检验比较比例，采用学生t检验或单因素方差分析比较连续变量。p值<0.05被认为具有统计学意义。

结果

在研究期间，该医院共发生700例死亡病例，其中211例（30.1%）发生在ICU，88例（12.6%）发生在非ICU。与ICU相比，非ICU在上午6点至中午12点之间的死亡人数更多（38%对21%；p = 0.004）。在ICU，我们观察到21%的死亡发生在上午6点至中午12点之间，30%发生在中午12点至下午6点之间，26%发生在下午6点至凌晨12点之间，24%发生在凌晨12点至上午6点之间（p = 0.13）；而在非ICU，38%的死亡发生在上午6点至中午12点之间，18%发生在中午12点至下午6点之间，19%发生在下午6点至凌晨12点之间，25%发生在凌晨12点至上午6点之间（p = 0.005）。