Imperial College London
Alternate

ProfessorStephenBrett

Faculty of Medicine, Department of Surgery & Cancer

Professor of Critical Care
 
 
 
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Contact

 

+44 (0)20 3313 4521stephen.brett Website

 
 
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Location

 

Hammersmith House 570Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Galloway:2018:10.1097/CCM.0000000000002837,
author = {Galloway, M and Hegarty, A and McGill, S and Arulkumaran, N and Brett, SJ and Harrison, DA},
doi = {10.1097/CCM.0000000000002837},
journal = {Critical Care Medicine},
pages = {290--299},
title = {The effect of intensive care unit out-of-hours admission on mortalityA systematic review and meta-analysis},
url = {http://dx.doi.org/10.1097/CCM.0000000000002837},
volume = {46},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objectives: Organizational factors are associated with outcome ofcritically ill patients and may vary by time of day and day of week.We aimed to identify the association between out-of-hours admissionto critical care and mortality.Data Sources: MEDLINE (via Ovid) and EMBASE (via Ovid).Study Selection: We performed a systematic search of the literaturefor studies on out-of-hours adult general ICU admission onpatient mortality.Data Extraction: Meta-analyses were performed and Forest plotsdrawn using RevMan software. Data are presented as odds ratios([95% CIs], p values).Data Synthesis: A total of 16 studies with 902,551 patients wereincluded in the analysis with a crude mortality of 18.2%. Fourteenstudies with 717,331 patients reported mortality rates bytime of admission and 11 studies with 835,032 patients by dayof admission. Admission to ICU at night was not associated withan increased odds of mortality compared with admissions duringthe day (odds ratio, 1.04 [0.98–1.11]; p = 0.18). However, admissionsduring the weekend were associated with an increased oddsof death compared with ICU admissions during weekdays (1.05[1.01–1.09]; p = 0.006). Increased mortality associated withweekend ICU admissions compared with weekday ICU admissionswas limited to North American countries (1.08 [1.03–1.12];p = 0.0004). The absence of a routine overnight on-site intensivistwas associated with increased mortality among weekendICU admissions compared with weekday ICU admissions (1.11[1.00–1.22]; p = 0.04) and nighttime admissions compared withdaytime ICU admissions (1.11 [1.00–1.23]; p = 0.05).Conclusions: Adjusted risk of death for ICU admission was greaterover the weekends compared with weekdays. The absence of adedicated intensivist on-site overnight may be associated withincreased mortality for acute admissions. These results need tobe interpreted in context of the organization of local healthcareresources before changes to healthcare policy are impleme
AU  - Galloway,M
AU  - Hegarty,A
AU  - McGill,S
AU  - Arulkumaran,N
AU  - Brett,SJ
AU  - Harrison,DA
DO  - 10.1097/CCM.0000000000002837
EP  - 299
PY  - 2018///
SN  - 0090-3493
SP  - 290
TI  - The effect of intensive care unit out-of-hours admission on mortalityA systematic review and meta-analysis
T2  - Critical Care Medicine
UR  - http://dx.doi.org/10.1097/CCM.0000000000002837
UR  - http://hdl.handle.net/10044/1/51672
VL  - 46
ER  -
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