Wujtewicz Magdalena A, Suszyńska-Mosiewicz Aleksandra, Sawicka Wioletta, Piankowski Arkadiusz, Dylczyk-Sommer Anna, Owczukl Radosław, Wujtewicz Maria
Klinika Anestezjologii i Intensywnej Terapii, Gdański Uniwersytet Medyczny.
Anestezjol Intens Ter. 2011 Oct-Dec;43(4):230-3.
Among many factors that may affect mortality among ITU patients, the time of admission has been reported to play some, but ill-defined role. In the retrospective study, we analysed the time of admission, severity of the underlying disease, clinical status on admission and mortality among adult patients treated in a single ITU over a six-year period.
We compared the mortality of patients who were admitted during daytime (7 a.m. to 6:59 p.m.) and at night (7 p.m. to 6:59 a.m.). We also compared those admitted on weekdays (Monday 7 p.m. to Friday 6:59 a.m.) to those admitted during weekends (Friday 7 p.m. to Monday 7 a.m.). The patients condition was assessed using the APACHE II scale. Brain dead organ donors and readmissions were excluded from the analysis.
The retrospective study involved the data of 1789 patients. Mortality was higher in patients who were admitted during the night and during weekends, when compared to daytime and weekdays, respectively. Mortality was also higher in patients admitted directly from the operating theatre after emergency surgery, but only during nights and weekends. The following independent factors in ITU mortality have been identified: length of ITU stay (OR 1.015; % CI 1.005-1.024), admission from a hospital ward (OR 1.39; 95% CI 1.04-1.86) and APACHE II score (OR 1.177; 95% CI 1.156-1.198).
Time of admission has not been identified as a single independent factor of ITU mortality, but admissions at night and during weekends were associated with higher mortality, probably because of emergency conditions.
在可能影响重症监护病房（ITU）患者死亡率的诸多因素中，入院时间据报道起到了一定作用，但作用尚不明确。在这项回顾性研究中，我们分析了一家单一重症监护病房在六年期间收治的成年患者的入院时间、基础疾病严重程度、入院时的临床状况及死亡率。
我们比较了白天（上午7点至下午6点59分）入院患者与夜间（下午7点至上午6点59分）入院患者的死亡率。我们还比较了工作日（周一晚上7点至周五上午6点59分）入院患者与周末（周五晚上7点至周一上午7点）入院患者的死亡率。使用急性生理与慢性健康状况评分系统（APACHE II）评估患者病情。分析排除脑死亡器官捐献者和再次入院患者。
这项回顾性研究纳入了1789例患者的数据。与白天和工作日入院患者相比，夜间和周末入院患者的死亡率更高。急诊手术后直接从手术室入院的患者死亡率也更高，但仅在夜间和周末如此。已确定以下重症监护病房死亡率的独立影响因素：重症监护病房住院时长（比值比1.015；可信区间1.005 - 1.024）、从医院病房入院（比值比1.39；95%可信区间1.04 - 1.86）及APACHE II评分（比值比1.177；95%可信区间1.156 - 1.198）。
入院时间尚未被确定为重症监护病房死亡率的单一独立因素，但夜间和周末入院与较高死亡率相关，可能是由于紧急情况所致。
