Off hour admission to an intensivist-led ICU is not associated with increased mortality 英文参考文献.docVIP

Available online /content/13/3/R84 Research Open Access Vol 13 No 3 Off hour admission to an intensivist-led ICU is not associated with increased mortality Iwan A Meynaar1, Johan I van der Spoel2, Johannes H Rommes3, Margot van Spreuwel-Verheijen1, Rob J Bosman2 and Peter E Spronk3,4 1ICU, Reinier de Graaf Groep, Reinier de Graafweg 3-11, 2625 AD, Delft, Netherlands 2ICU, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC, Amsterdam, Netherlands 3ICU, Gelre Hospitals, Albert Schweitzerlaan 31 7334 DZ, Apeldoorn, Netherlands 4ICU, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands Corresponding author: Iwan A Meynaar, meynaar@rdgg.nl Received: 13 Feb 2009 Revisions requested: 25 Mar 2009 Revisions received: 27 Apr 2009 Accepted: 5 Jun 2009 Published: 5 Jun 2009 Critical Care 2009, 13:R84 (doi:10.1186/cc7904) This article is online at: /content/13/3/R84 ? 2009 Meynaar et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction Caring for the critically ill is a 24-hour-a-day responsibility, but not all resources and staff are available during off hours. We evaluated whether intensive care unit (ICU) admission during off hours affects hospital mortality. Results A total of 6725 patients were included in the study, 4553 (67.7%) admitted during daytime and 2172 (32.3%) admitted during off hours. Baseline characteristics of patients admitted during daytime were significantly different from those of patients admitted during off hours. Hospital mortality was 767 (16.8%) in patients admitted during daytime and 469 (21.6%) in patients admitted during off hours (P 0.001, unadjusted odds ratio 1.36, 95%CI 1.20–1.55). Standardized mortality ratios were simil