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내과계 중환자실 입실 시간에 따른 급성 중증 환자의 예후

Effect of Admission Time to the Medical Intensive Care Unit on Acute Critical Patient Outcomes

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초록

Background: The initial management of acute critical patients is important. However, not all hospital facilities and staff are available during off-duty time. We determined the effects of intensive care unit (ICU) admission time on patient outcomes. Methods: This retrospective cohort study was conducted in a 28-bed medical ICU in 1 tertiary university hospital. Patients who were admitted between 1 March 2009 and 31 August 2009 were divided according to the time of admission into the “duty time group” (9 AM-5 PM on weekdays) and the “off-duty time group” (5 PM? 9 AM on weekdays and at any time on weekends). The baseline characteristics and clinical outcomes were compared between these two groups. The primary endpoint of this study was hospital mortality; the secondary endpoints were ICU mortality and length of ICU stay, hospital length of stay, and mechanical ventilation time. Results: Two hundred eight (64.8%) of 321 enrolled patients were admitted during off-duty time. The baseline characteristics between the 2 groups were not significantly different. Hospital mortality was 37 (32.7%) in the “duty time group” and 82 (38.4%) in the “off-duty time group” (p=0.237). There were no significant differences in secondary endpoints between the two groups. Conclusions: Off-duty time admission to the ICU had no effect on hospital and ICU mortality, length of hospital and ICU stay, and mechanical ventilation time compared to duty time admission.

Abstract

Background: The initial management of acute critical patients is important. However, not all hospital facilities and staff are available during off-duty time. We determined the effects of intensive care unit (ICU) admission time on patient outcomes. Methods: This retrospective cohort study was conducted in a 28-bed medical ICU in 1 tertiary university hospital. Patients who were admitted between 1 March 2009 and 31 August 2009 were divided according to the time of admission into the “duty time group” (9 AM-5 PM on weekdays) and the “off-duty time group” (5 PM? 9 AM on weekdays and at any time on weekends). The baseline characteristics and clinical outcomes were compared between these two groups. The primary endpoint of this study was hospital mortality; the secondary endpoints were ICU mortality and length of ICU stay, hospital length of stay, and mechanical ventilation time. Results: Two hundred eight (64.8%) of 321 enrolled patients were admitted during off-duty time. The baseline characteristics between the 2 groups were not significantly different. Hospital mortality was 37 (32.7%) in the “duty time group” and 82 (38.4%) in the “off-duty time group” (p=0.237). There were no significant differences in secondary endpoints between the two groups. Conclusions: Off-duty time admission to the ICU had no effect on hospital and ICU mortality, length of hospital and ICU stay, and mechanical ventilation time compared to duty time admission.

참고문헌 (24)

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