Outcome of patients admitted during off hours in Moroccan intensive care unit

Abstract

Mina Elkhayari,1 Othmane Dilai,2 Amra Ziadi,2 Abdelhamid Hachimi,1 Mohammed Abdenasser Samkaoui2 1Medical Intensive Care Unit, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, University Cadi Ayyad, Marrakech, Morocco; 2Surgical Intensive Care Unit, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, University Cadi Ayyad, Marrakech, Morocco Background: The first few hours after intensive care unit (ICU) admission, where a patient's condition is stabilized and treatment plans are formulated, are crucial to patient outcome. Although admission of patients who are unstable to ICU occurs 24 hours a day, not all units maintain the same level of staffing during off hours. We evaluated whether ICU admission during off hours affects mortality in a Moroccan ICU with the same level of staffing. Methods: This prospective study was carried out at an ICU in a Moroccan hospital during 6 months. Demographic, clinic, acute physiology and chronic health evaluation score, length of stay, time of admission (day time or off hours), and ICU mortality data were collected. The mortality in the ICU was the end point of the study. Logistic regression analysis was used to identify risk factors associated with ICU mortality at various day and time of admission. Results: A total of 195 patients were included in the study; 125 (63.6%) were admitted during the day time and 70 (36.4%) were admitted during off hours. Most of the patients admitted during the off hours were male (75% versus 58% during the day time, P=0.01). Patients admitted in off hours after traumatism were more frequent than those admitted during the day time (64% versus 24%, P=0.001). There was no significant difference in ICU mortality for time of ICU admission (P=0.05). Conclusion: We can conclude that off hours care is not necessarily inadequate. For ICU managers, it is important to know how to maintain adequate quality of care around the clock. Keywords: intensive care unit, day time, off hours, mortality