Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Reflections on off hour admissions to ICU. | Available online http content 13 5 418 Letter Reflections on off hour admissions to ICU Declan Byrne Siok Li Chung and Bernard Silke Department of Pharmacology and Therapeutics University of Dublin Trinity College and the GEMS Directorate St James Hospital Dublin 8 Ireland Corresponding author Bernard Silke bsilke@ See related research by Meynaar et al. http content 13 3 R84 Published 25 September 2009 This article is online at http content 13 5 418 2009 BioMed Central Ltd Critical Care 2009 13 418 doi cc8030 In the June issue of this journal Meynaar and colleagues 1 report that there was no excess mortality observed for off hours admissions to ICU once an adjustment was made for acute illness severity 1 . We have previously described a 50 relative risk reduction in all cause mortality pursuant to the establishment of an acute medical admission unit 2 . In our study only of 23 172 emergency medical admissions were admitted to the ICU. For all patients admitted between 2002 and 2008 we observed Table 1 an increased mortality for evening admissions admissions between and hours with an odds ratio OR of 95 confidence interval CI . The out of hours effect on 30-day mortality was independently predictive despite adjustment for other major outcome predictors including acute illness severity Charlson index OR 95 CI and an ICU admission OR 95 CI . The evening effect remained constant over 7 years. For the subset of 894 patients admitted to our ICU there was no out of hours effect. This could be explained by lack of power to detect such an effect in the subgroup or perhaps patient selection factors for ICU level care. We could hypothesize that the increased mortality risk of evening admissions reflected factors including congestion staff fatigue or out of hours resource deficit. However although the implementation of our acute medical admission unit lowered .
