Chest
Clinical Investigations in Critical CareThe Hospital Mortality of Patients Admitted to the ICU on Weekends
Section snippets
Materials and Methods
In this cohort study, we reviewed the prospectively collected APACHE (acute physiology and chronic health evaluation) III database of patients admitted to some of the ICUs of the Mayo Clinic (Rochester, MN) from October 1994 through September 2002. The Mayo Foundation Institutional Review Board approved the study.
Results
There were 41,197 ICU admissions during the study period, of which 30,234 were first admissions. Excluding 1,150 patients who did not authorize their medical records to be reviewed for research, 29,084 patients were included in the study. Patients were predominantly white (95.5%). The weekend ICU admissions comprised 27.9% of the study population (8,108 patients). Of the 15,705 ICU admissions through 1998, 4,019 patients (25.6%) had been admitted on weekends, compared to 4,089 of 13,379
Discussion
This study examined whether weekend ICU admission is an independent risk factor for mortality in > 29,000 patients who had been admitted to an academic medical center. Using the APACHE III prognostic system for measuring severity of illness and adjusting for variables that may influence hospital mortality, our results showed that weekend ICU admission was not associated with an overall increased risk of hospital death. However, weekend ICU admission was associated with increased hospital
Conclusion
The current study shows that weekend ICU admission is not significantly associated with overall increased adjusted hospital mortality. As long as adequate staffing is maintained, and necessary diagnostic and therapeutic modalities are available, weekend ICU admission need not be associated with poor patient outcome. However, with the anticipated shortage of critical care physicians, registered nurses, and other health-care providers, and with the pressure on medical centers to cut costs,
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This research was supported by the Anesthesia Clinical Research Unit and by the Pulmonary and Critical Care Division Research Fund, Mayo Clinic and Foundation.