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Association Between ICU Admission During Morning Rounds and Mortality.
Chest. 2009 Jun 8;
Authors: Afessa B, Gajic O, Morales IJ, Keegan MT, Peters SG, Hubmayr RD
Background No previous study has evaluated the association between admission to ICUs (ICU) during round time and patient outcome. The objective of this study is to determine the association between round time admission and patient outcome. Methods This retrospective study included 49,844 patients admitted from October 1994 to December 2007, 3,580 round time (8:00 AM to 10:59 AM) and 46,264 nonround time (from 1:00 PM to 6:00 AM), to 4 (2 surgical, 1 medical, and 1 multi-specialty) ICUs of an academic medical center. The medical ICU had 24/7 intensivist coverage during the last 2 years of the study. We compared the baseline characteristics and outcome of patients admitted to the ICU between the two groups. Data were abstracted from the Acute Physiology and Chronic Health Evaluation (APACHE) III database. Results The round and nonround groups were similar in gender, ethnicity, and age. The predicted hospital mortality rate of the round time group was higher (17.4% Vs 12.3%, p < 0.001). The hospital length of stay was similar between the two groups. The round time group had higher hospital mortality (16.2% vs 8.8%, p < 0.001). Most of the round time admissions and deaths occurred in the medical ICU. Round time admission was an independent risk factor for hospital death (odds ratio [95% confidence interval], 1.321 [1.178\N1.481]). This independent association was present for the whole study period except the last two years. Conclusions Patients admitted to ICU during morning rounds have higher severity of illness and mortality rate.
PMID: 19505985 [PubMed - as supplied by publisher]