Prin Meghan, Ji Ruoyu, Kadyaudzu Clement, Li Guohua, Charles Anthony
Assistant Professor, Department of Anesthesiology, 1878University of Colorado Medical Center, Aurora, CO, USA.
Department of Biostatistics, 33638Columbia University Mailman School of Public Health, New York, NY, USA.
Trop Doct. 2020 Oct;50(4):303-311. doi: 10.1177/0049475520936011. Epub 2020 Jul 9.
This prospective cohort study evaluated the associations of day and time of admission to the Intensive Care Unit (ICU) with hospital mortality at a referral hospital in Malawi, a low-income country in sub-Saharan Africa. Patients admitted to the ICU during the day (08:00-16:00) were compared to those admitted at night (16:01-07:59); patients admitted on weekdays (Monday-Friday) were compared to admissions on weekends/holidays. The primary outcome was hospital mortality. Most patients were admitted during daytime (56%) and on weekdays (72%). There was no difference in mortality between night and day admissions (58% vs. 56%, = 0.8828; hazard ratio [HR] = 1.09, 95% confidence interval [CI = 0.82-1.44, = 0.5614) or weekend/holiday versus weekday admissions (56% vs. 57%, = 0.9011; HR = 0.87, 95% CI = 0.62-1.21, = 0.4133). No interaction between time and day was found. These results may be affected by high overall hospital mortality.
这项前瞻性队列研究评估了在撒哈拉以南非洲的低收入国家马拉维的一家转诊医院，重症监护病房（ICU）的入院日期和时间与医院死亡率之间的关联。将白天（08:00 - 16:00）入住ICU的患者与夜间（16:01 - 07:59）入住的患者进行比较；将工作日（周一至周五）入院的患者与周末/节假日入院的患者进行比较。主要结局是医院死亡率。大多数患者在白天（56%）和工作日（72%）入院。夜间和白天入院患者的死亡率没有差异（58%对56%，P = 0.8828；风险比[HR] = 1.09，95%置信区间[CI] = 0.82 - 1.44，P = 0.5614），周末/节假日与工作日入院患者的死亡率也没有差异（56%对57%，P = 0.9011；HR = 0.87，95% CI = 0.62 - 1.21，P = 0.4133）。未发现时间和日期之间存在交互作用。这些结果可能受到医院总体死亡率较高的影响。
