ArticlePloS one2023
The off-hour effect on mortality in traumatic brain injury according to age group.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 9 citations in OpenAlex.
- Association between health system navigation factors and preventable trauma mortality in Western Cape, South Africa.International journal of emergency medicine · 2026Article
- The determinants for death in hospital following moderate to severe traumatic brain injury in Australia.Emergency medicine Australasia : EMA · 2025Article
- A machine learning model based on emergency clinical data predicting 3-day in-hospital mortality for stroke and trauma patients.Frontiers in neurology · 2025Article
- Is there a weekend effect in severe traumatic brain Injury? An observational, population-based study from the Norwegian Trauma registry.Brain & spine · 2025Article
- Effect of Daytime versus Nighttime on Prehospital Care and Outcomes after Severe Traumatic Brain Injury.Journal of clinical medicine · 2024Article
- Weekend Admission and Mortality in Patients With Traumatic Brain Injury: A Meta-analysis.Korean journal of neurotrauma · 2023Review
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTraumatic brain injury (TBI) is a time-sensitive and life-threatening medical condition. We hypothesized that off-hours, which includes night-time, weekends, and holidays, may influence mortality in TBI. Our study aimed to evaluate if the off-hours effect influences mortality in patients with TBI and whether this effect is dependent on the age group.
methodsThis study included patients who experienced TBI and were admitted to Chonnam National University Hospital (CNUH) between 2017 to 2020. The main exposure was arrival time at the emergency department (ED) (off-hours vs. working hours). The main outcome was mortality at hospital discharge. Multivariable logistic regression analysis was conducted to estimate the effect size of off-hours on mortality compared to that of working hours. We performed an interaction analysis between ED admission time and age group on study outcomes.
resultsA total of 2086 patients with TBI with intracranial injury who were transported by EMS were enrolled in our registry. In the multivariable logistic regression analysis, there was no significant difference in mortality (AOR, 95% CI (1.05 [0.54-1.81]) in patients visiting the ED during off-hours. In the interaction analysis, the effect measure of ED admission during off-hours on mortality was significant among younger people (0-17 years: 1.16 [1.03-1.31]), compared to that in other age groups (18-64 years: 1.02 [0.48-2.39] and 65-100 years (0.99 [0.51-2.23])).
conclusionsIn patients under 18 years old, admission during off-hours was associated with higher mortality at hospital discharge compared to admission during working-hours in patients with TBI with intracranial hemorrhage. EDs should be designed such that the same quality of emergency care is provided regardless of admission time.
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