Türk Yoğun Bakim Derneği Dergisi (Sep 2023)

Effect of the Timing of Admission Upon Patient Prognosis in the Intensive Care Unit: Off-hours and On-hours

  • Yeliz Bilir,
  • Fulya Ciyiltepe,
  • Dilara Çopur,
  • Kemal Tolga Saraçoğlu

DOI
https://doi.org/10.4274/tybd.galenos.2023.99705
Journal volume & issue
Vol. 21, no. 3
pp. 228 – 233

Abstract

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Objective:This study was planned to evaluate the clinical features and outcomes of patients hospitalized in intensive care units (ICUs) on-hours [workdays (WD)] and out of hours [time-off (TO)].Materials and Methods:Ethics committee approval was obtained for this study. Patients hospitalized in adult ICUs between July 2021 and January 2022 were retrospectively evaluated. The patients were divided into two groups: those who were accepted during on-hours (group WD, WD 08.00 am-05.00 pm) and out of hours (group TO; WD-05.01 pm-07.59 am, weekends, and all public holidays). The groups were compared in terms of patient characteristics and intensive care outcomes.Results:Of the 173 patients included in the study, 69.94% (n=121) were hospitalized during out-of-hours and 30.05% (n=52) during on-hours. The median age of the patients was 70.3±9.5 years, 58.4% were male and 41.6% were female. The number of patients hospitalized in TO was statistically significantly higher than the number of patients in WD (p=0.04). There was no significant difference between the two groups in terms of demographic data, except that chronic renal failure (18.2%, p=0.024) was more common as a comorbidity in TO patients. The need for continuous renal replacement therapies treatment, which is one of the reasons for ICU admission, was found to be significantly higher in TO patients (p=0.048). The length of stay in the ICU and intubation period was higher in group TO (p=0.006, p=0.022). It resulted in death in 34.1% of the patients. There was no significant difference in mortality and discharge between the groups.Conclusion:In our study, the clinical outcome was found to be similar in patients followed up in ICUs under WD and TO conditions. This result; This can be attributed to the fact that the shift team is not different in our hospital, the number of experienced health personnel is high, and the necessary diagnostic procedures are not delayed.

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