ArticleBMC health services research2015
Association Between Nighttime Discharge from the Intensive Care Unit and Hospital Mortality: A Multi-Center Retrospective Cohort Study.
Article in BMC health services research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Out-of-hours discharge from intensive care, in-hospital mortality and intensive care readmission rates: a systematic review and meta-analysis.Intensive care medicine · 2018Pooled it
- Indicators of intensive care unit capacity strain: a systematic review.Critical care (London, England) · 2018Pooled it
- Association between time of discharge from ICU and hospital mortality: a systematic review and meta-analysis.Critical care (London, England) · 2016Pooled it
- Mortality and readmission rates of patients discharged in-hours and out-of-hours from a British ICU over a 3-year period.Scientific reports · 2022Article
- Incidence, risk and impact of ICU readmission on patient outcomes and resource utilisation in tertiary level ICUs in Nepal: A cohort study.Wellcome open research · 2022Article
- A retrospective observational study of daytime and nighttime transfers from the intensive care unit: through the lens of critical care response teams.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021Observational
- Assessment of Costs of Avoidable Delays in Intensive Care Unit Discharge.JAMA network open · 2020Observational
- Transition of care at discharge from the Intensive Care Unit: a scoping review.Revista latino-americana de enfermagem · 2020Article
- "Hang on, I haven't seen this patient yet…": near simultaneous admissions to the ICU.Intensive care medicine · 2019Article
- Lessons learned and new directions regarding Discharge Direct from Adult Intensive Care Units Sent Home (DISH): A narrative review.Journal of the Intensive Care Society · 2019Review
- Transfer Time from the Intensive Care Unit and Patient Outcome: A Retrospective Analysis from a Tertiary Care Hospital in India.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2019Article
- Going back to the ward-transitioning care back to the ward team.Translational pediatrics · 2018Review
- [Unplanned admission or readmission to the intensive care unit : Avoidable or fateful?]Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2018Review
- Nighttime intensive care unit discharge and outcomes: A propensity matched retrospective cohort study.PloS one · 2018Article
- [Benefits of medical emergency teams : Mortality on normal wards and readmission to intensive care wards].Der Unfallchirurg · 2018Review
- Barriers and facilitators to improve safety and efficiency of the ICU discharge process: a mixed methods study.BMC health services research · 2017Article
- The impact of critical care transition programs on outcomes after intensive care unit (ICU) discharge: can we get there from here?Journal of thoracic disease · 2016Article
- Quality and performance measures of strain on intensive care capacity: a protocol for a systematic review.Systematic reviews · 2015Article
- Prognostic impact of the time of admission and discharge from the intensive care unit.Revista Brasileira de terapia intensivaObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe aimed to determine the impact of nighttime discharge from the intensive care unit (ICU) to the ward on hospital mortality and readmission rates in consecutive critically ill patients admitted to five Canadian ICUs. We hypothesized that hospital mortality and readmission rates would be higher for patients discharged after hours compared with discharge during the day.
methodsA multi-center retrospective cohort study was carried out at five hospitals in Edmonton, Canada, between July 2002 and December 2009. Nighttime discharge was defined as discharge from the ICU occurring between 07:00 pm and 07:59 am. Logistic regression analysis was used to explore the associations between nighttime discharge and outcomes.
resultsOf 19,622 patients discharged alive from the ICU, 3,505 (17.9%) discharges occurred during nighttime. Nighttime discharge occurred more commonly among medical than surgical patients (19.9% vs. 13.8%, P < 0.001) and among those with more comorbid conditions, compared with daytime discharged patients. Crude hospital mortality (11.8% versus 8.8%, P < 0.001) was greater for nighttime discharged as compared to daytime discharged patients. In a multivariable analysis, after adjustment for comorbidities, diagnosis and source of admission, nighttime discharge remains associated with higher mortality (odds ratio [OR] 1.29; 95% CI, 1.14 to 1.46, P < 0.001). This finding was robust in two sensitivity analyses examining discharges occurring between 00:00 am and 04:59 am (OR 1.28; 1.12-1.47; P < 0.001) and for those who died within 48 h of ICU discharge without readmission (OR 1.24; 1.07-1.42, P = 0.002). There was no difference in ICU readmission for nighttime compared with daytime discharges (7.4% vs. 6.9 %, p = 0.26). However, rates were higher for nighttime discharges in community compared with tertiary hospitals (7.7% vs. 5.7%, P = 0.023).
conclusionsIn a large integrated health region, 1 in 5 ICU patients are discharged at nighttime, a factor with increasing occurrence during our study and shown to be independently associated with higher hospital mortality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.