• Thiago Domingos Corrêa, Ponzoni Carolina Rodrigues CR 0000-0002-3773-5962 Dept. of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil., Roberto Rabello Filho, Neto Ary Serpa AS 0000-0003-1520-9387 Dept. of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil. , Chaves Renato Carneiro de Freitas RCF Dept. of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil., Andreia Pardini, Assunção Murillo Santucci Cesar MSC Dept. of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil., Guilherme De Paula Pinto Schettino, and Danilo Teixeira Noritomi.
• Dept. of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.
• Plos One. 2018 Jan 1; 13 (12): e0207268.

BackgroundNighttime ICU discharge, i.e., discharge from the ICU during the night hours, has been associated with increased readmission rates, hospital length of stay (LOS) and in-hospital mortality. We sought to determine the frequency of nighttime ICU discharge and identify whether nighttime ICU discharge is associated with worse outcomes in a private adult ICU located in Brazil.MethodsPost hoc analysis of a cohort study addressing the effect of ICU readmissions on outcomes. This retrospective, single center, propensity matched cohort study was conducted in a medical-surgical ICU located in a private tertiary care hospital in São Paulo, Brazil. Based on time of transfer, patients were categorized into nighttime (7:00 pm to 6:59 am) and daytime (7:00 am to 6:59 pm) ICU discharge and were propensity-score matched at a 1:2 ratio. The primary outcome of interest was in-hospital mortality.ResultsAmong 4,313 eligible patients admitted to the ICU between June 2013 and May 2015, 1,934 patients were matched at 1:2 ratio [649 (33.6%) nighttime and 1,285 (66.4%) daytime discharged patients]. The median (IQR) cohort age was 66 (51-79) years and SAPS III score was 43 (33-55). In-hospital mortality was 6.5% (42/649) in nighttime compared to 5.6% (72/1,285) in daytime discharged patients (OR, 1.17; 95% CI, 0.79 to 1.73; p = 0.444). While frequency of ICU readmission (OR, 0.95; 95% CI, 0.78 to 1.29; p = 0.741) and length of hospital stay did not differ between the groups, length of ICU stay was lower in nighttime compared to daytime ICU discharged patients [1 (1-3) days vs. 2 (1-3) days, respectively, p = 0.047].ConclusionIn this propensity-matched retrospective cohort study, time of ICU discharge did not affect in-hospital mortality.

14 keywords...

hide…