Fahel Bruno V B, Manciola Marina, Lima Gabriel, Barbosa Manoel H, Starteri Chuva, Ramos João Gabriel Rosa, Caldas Juliana R, Passos Rogério da Hora
Escola Bahiana de Medicina e Saúde Pública (EBMSP).
Faculdade de Medicina da Bahia (UFBA).
Medicine (Baltimore). 2020 Nov 20;99(47):e23256. doi: 10.1097/MD.0000000000023256.
Admission to the emergency department (ED) on weekends has been associated with an increase in mortality and poor outcomes, but the associated findings are not consistent. It has been hypothesized that this association may be due to lower adherence to standards of care.This study was conducted to evaluate whether weekend admissions to the ED increases the time to antibiotic administration in septic patients.A retrospective cohort study of adult patients who were included in the sepsis protocol at a tertiary ED between January 2015 and December 2017 was performed. The sepsis protocol was activated for all patients with suspected severe infection.A total of 831 patients with a mean age of 59 ± 21 years were evaluated, of whom 217 (26.1%) were admitted on weekends. In addition, 391 (47.1%) patients were male, and 84 (10.1%) died in the hospital. Overall, the mean sequential organ failure assessment score was 2 ± 1.9, and the mean Charlson comorbidity index was 3.7 ± 3. The time to antibiotic administration was similar between patients admitted on weekends (36.29 ± 50 minutes CI 95%) and patients admitted on weekdays (44.44 ± 69 minutes CI 95%), P = .06; U = 60174.0. Additionally, mortality was similar in both groups of patients, with a 10.3% mortality rate on weekdays and a 9.8% mortality rate on weekends, P = 821.In this cohort of patients with suspicion of sepsis in the ED, admission on weekends was not associated with increased delays in antibiotic therapy or higher mortality rates.
周末入住急诊科（ED）与死亡率增加及不良预后相关，但相关研究结果并不一致。据推测，这种关联可能是由于对护理标准的依从性较低。本研究旨在评估周末入住急诊科是否会增加脓毒症患者使用抗生素的时间。对2015年1月至2017年12月期间在一家三级急诊科纳入脓毒症治疗方案的成年患者进行了一项回顾性队列研究。对所有疑似严重感染的患者启动脓毒症治疗方案。共评估了831例平均年龄为59±21岁的患者，其中217例（26.1%）在周末入院。此外，391例（47.1%）患者为男性，84例（10.1%）在医院死亡。总体而言，序贯器官衰竭评估平均分是2±1.9，查尔森合并症指数平均分是3.7±3。周末入院患者与工作日入院患者使用抗生素的时间相似（36.29±50分钟，95%置信区间）与（44.44±69分钟，95%置信区间），P = 0.06；U = 60174.0。此外，两组患者的死亡率相似，工作日死亡率为10.3%，周末死亡率为9.8%，P = 0.82。在这组急诊科疑似脓毒症的患者中，周末入院与抗生素治疗延迟增加或死亡率升高无关。
