Critical Care

Critical care wardCritical care involves the care of the sickest patients in the hospital. Critically ill patients have usually been through a significant insult to their body (such as trauma, infection, burn) and have developed organ failure and require life-support. Critical Care is the largest theme bringing together clinicians and scientists from diverse backgrounds and includes collaborative research from hospitals throughout north-west London. Investigations range from evaluating biological mechanisms of organ failure through to the development of innovative technologies which allow the short-term and long-term support and recovery of organs. 

Many people are exposed to the environment of an Intensive care unit (ICU) either personally or through a family member. It is often a life-changing event and our work aims to reduce this impact facilitating post-ICU recovery.

Research themes:

Citation

BibTex format

@article{Arulkumaran:2016:bja/aew398,
author = {Arulkumaran, N and Harrison, DA and Brett, SJ},
doi = {bja/aew398},
journal = {British Journal of Anaesthesia},
pages = {112--122},
title = {Association between day and time of admission to critical care and acute hospital outcome for unplanned admissions to adult general critical care units: cohort study exploring the ‘weekend effect’},
url = {http://dx.doi.org/10.1093/bja/aew398},
volume = {118},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background. We aimed to identify any association between day and time of admission to critical care and acute hospital outcome.Methods. We conducted a cohort study using prospectively collected data from the national clinical audit of adult critical care. We included 195 428 unplanned admissions from 212 adult general critical care units in England, Wales and Northern Ireland, between April 1, 2013 and March 31, 2015 in the analysis.Results. Hourly admission rates for unplanned admissions varied more than three-fold during the 24 h cycle. Overall acute hospital mortality was 26.8%. Before adjustment, acute hospital mortality was similar between weekends and weekdays but was significantly lower for admissions at night compared with the daytime (−3.4%, −3.8 to −3.0%; P<0.001). After adjustment for casemix, there remained no difference between weekends and weekdays (−0.0%, −0.4 to +0.3%; P=0.87) or between nighttime and daytime (−0.2%, −0.5 to +0.1%; P=0.21). Delays in admission were reported for 4.3% of admissions and were slightly more common during weekdays than weekends and in the daytime than at night. Delayed admission was associated with a small increase in acute hospital mortality, but adjusting for this did not affect the estimates of the effect of day and time of admission.Conclusions. The day of week and time of admission have no influence on patient mortality for unplanned admissions to adult general critical care units within the UK. Ways to improve critical care and hospital systems to minimize delays in admission and potentially improve outcomes need to be ascertained in future research.
AU  - Arulkumaran,N
AU  - Harrison,DA
AU  - Brett,SJ
DO  - bja/aew398
EP  - 122
PY  - 2016///
SN  - 1471-6771
SP  - 112
TI  - Association between day and time of admission to critical care and acute hospital outcome for unplanned admissions to adult general critical care units: cohort study exploring the ‘weekend effect’
T2  - British Journal of Anaesthesia
UR  - http://dx.doi.org/10.1093/bja/aew398
UR  - http://hdl.handle.net/10044/1/41749
VL  - 118
ER  -
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