Ann Med Med Res | Volume 1, Issue 1 | Research Article | Open Access
Kazuhiko Sekine*, Ken-Ichiro Sasao, Shiho Irino, Yoko Sugawara and Motojiro Takebe
Department of Emergency and Critical Care Medicine, Tokyo Saiseikai Central Hospital, Japan
*Correspondance to: Kazuhiko Sekine
Fulltext PDFBackground: The aim of this study is to elucidate the outcomes of patients admitted to the Emergency Department (ED) of our tertiary care center by time or day of arrival at the ED, which is known as “nighttime or weekend effect’.
Methods: Of all patients admitted to the ED of our tertiary care center from July 1, 2012 to July 31, 2017. We collected data about the clinical severity, including the Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores at admission, and assessed the impact of time and day (daytime/nighttime, weekday/weekend, regular business hours/out-of-hours, and holidays/non-holidays) of the ED arrival as well as the performance of emergent treatment, including endovascular, endoscopic, and surgical interventions, on the cumulative 90-day in-hospital mortality of ED patients.
Results: No significant differences were observed among the aforementioned factors, excluding business hours/out-of-hours and emergency intervention. In patients who did not receive an emergency intervention, the 90-day out-of-hours, in-hospital mortality was significantly higher than that at business hours (p =0.01); however, in patients who received an emergency intervention, the mortality was similar between business hours and out-of-hours (p =0.99). In patients who did not receive an emergency intervention, SOFA and APACHE II scores were higher at out-of-hours than those at business hours. Conclusions: In patients admitted to the ED of our tertiary care center in Japan, the 90-day mortality increased in correlation with the out-of-hours ED arrival. The increased out-of-hours mortality could be improved by an emergency intervention as well as by arriving at business hours in patients who benefit from an emergency intervention.
Weekend effect; Nighttime effect; Tertiary care center; Emergency admission; Outof-hours effect
Sekine K, Sasao K-I, Irino S, Sugawara Y, Takebe M. Increased Mortality was not Associated with Weekend or Nighttime but was Associated with Outof-Hours in Patients Admitted to the Emergency Department of a Tertiary Care Center: Possibilities of Emergency Intervention. Ann Med Medical Res. 2018; 1: 1003.