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Prognostic impact of the time of admission and discharge from the intensive care unit

ABSTRACT

Objective:

To determine the impact of the day and time of admission and discharge from the intensive care unit on mortality.

Methods:

Prospective observational study that included patients admitted to the intensive care unit of the Hospital Maciel in Montevideo between April and November 2014.

Results:

We analyzed 325 patients with an average age of 55 (36 - 71) years and a SAPS II value of 43 (29 - 58) points. No differences were found in the mortality of patients in the intensive care unit when time of admission (35% on the weekend versus 31% on weekdays, p = ns) or the hour of entry (35% at night versus 31% in the daytime, p = ns) were compared. The time of discharge was associated with higher hospital mortality rates (57% for weekend discharges versus 14% for weekday discharges, p = 0.000). The factors independently associated with hospital mortality after discharge from the intensive care unit were age > 50 years (OR 2.4, 95%CI, 1.1 - 5.4) and weekend discharge (OR 7.7, 95%CI, 3.8-15.6).

Conclusion:

This study identified the time of discharge from the intensive care unit as a factor that was independently associated with hospital mortality.

Keywords:
Patient admission; Patient discharge; Prognosis; Mortality; Intensive care units

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