PMID- 19635157
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20110714
LR  - 20220408
IS  - 1752-2897 (Print)
IS  - 1752-2897 (Electronic)
IS  - 1752-2897 (Linking)
VI  - 3
DP  - 2009 Jul 27
TI  - Hospital mortality among major trauma victims admitted on weekends and evenings: 
      a cohort study.
PG  - 8
LID - 10.1186/1752-2897-3-8 [doi]
AB  - BACKGROUND: Patient care may be inconsistent during off hours. We sought to 
      determine whether victims of major trauma admitted to hospital on evenings, 
      nights, and weekends suffer increased mortality rates. All victims of major 
      trauma admitted to all four major acute care hospitals in the Calgary Health 
      Region between April 1, 2002 and March 31, 2006 were included. Clinical and 
      outcome information was obtained from regional databases. Weekends were defined 
      as anytime Saturday or Sunday, evenings as 18:00-22:59, and nights as 
      23:00-07:59. RESULTS: Four thousand patients were included; 2,901 (73%) were 
      male, the median age was 39.5 [inter-quartile range (IQR), 22.4-58.2] years, and 
      the median injury severity score (ISS) was 20 (IQR, 16-26). Thirty-five percent 
      (1,405) of patients were admitted on a weekend, 30% (1,197) during evenings, and 
      36% (1,422) at night. Seventy-eight percent (3,106) of cases presented during the 
      "after hours" (evenings, nights, and/or weekends). The in-hospital case-fatality 
      rate was 447 (11%), and was not significantly different during daytime 
      (165/1,381; 37%), evening (128/1,197; 30%), and night (154/1,422; 36%) admissions 
      (p = 0.53), or among patients admitted on weekends as compared to weekdays 
      (157/1,405; 11% vs. 290/2,595; 11%; p = 1.0). Admission during the after hours as 
      compared to business hours (343/3,106; 11% vs. 104/894; 12%; p = 0.63) did not 
      increased risk. A multivariable logistic regression model was developed to assess 
      factors associated with in-hospital death (n = 3,891). Neither admission on 
      weekends nor on evenings or nights increased the risk for in-hospital mortality. 
      CONCLUSION: In our region, the time of admission during the day or day of the 
      week does not influence the risk for adverse outcome and may reflect our highly 
      developed multi-hospital acute care and trauma system.
FAU - Laupland, Kevin B
AU  - Laupland KB
AD  - Department of Medicine, University of Calgary and Calgary Health Region, Calgary, 
      Alberta, Canada. kevin.laupland@calgaryhealthregion.ca.
FAU - Ball, Chad G
AU  - Ball CG
FAU - Kirkpatrick, Andrew W
AU  - Kirkpatrick AW
LA  - eng
PT  - Journal Article
DEP - 20090727
PL  - England
TA  - J Trauma Manag Outcomes
JT  - Journal of trauma management & outcomes
JID - 101294910
PMC - PMC2731032
EDAT- 2009/07/29 09:00
MHDA- 2009/07/29 09:01
PMCR- 2009/07/27
CRDT- 2009/07/29 09:00
PHST- 2009/03/31 00:00 [received]
PHST- 2009/07/27 00:00 [accepted]
PHST- 2009/07/29 09:00 [entrez]
PHST- 2009/07/29 09:00 [pubmed]
PHST- 2009/07/29 09:01 [medline]
PHST- 2009/07/27 00:00 [pmc-release]
AID - 1752-2897-3-8 [pii]
AID - 10.1186/1752-2897-3-8 [doi]
PST - epublish
SO  - J Trauma Manag Outcomes. 2009 Jul 27;3:8. doi: 10.1186/1752-2897-3-8.