| Association between ICU admission during morning rounds and mortality. | |
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MedLine Citation:
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PMID: 19505985 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: No previous study has evaluated the association between admission to ICUs during round time and patient outcome. The objective of this study was to determine the association between round-time ICU admission and patient outcome. METHODS: This retrospective study included 49,844 patients admitted from October 1994 to December 2007 to four ICUs (two surgical, one medical, and one multispecialty) of an academic medical center. Of these patients, 3,580 were admitted to the ICU during round time (8:00 am to 10:59 am) and 46,264 were admitted during nonround time (from 1:00 pm to 6:00 am). The medical ICU had 24-h/7-day per week 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-time and non-round-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% predicted, respectively; p < 0.001). The hospital length of stay was similar between the two groups. The round-time group had a higher hospital mortality rate (16.2% vs 8.8%, respectively; p < 0.001). Most of the round-time ICU admissions and deaths occurred in the medical ICU. Round-time admission was an independent risk factor for hospital death (odds ratio, 1.321; 95% CI, 1.178 to 1.481). This independent association was present for the whole study period except for the last 2 years. CONCLUSIONS: Patients admitted to the ICU during morning rounds have higher severity of illness and mortality rates. |
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Authors:
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Bekele Afessa; Ognjen Gajic; Ian J Morales; Mark T Keegan; Steve G Peters; Rolf D Hubmayr |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-06-08 |
Journal Detail:
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Title: Chest Volume: 136 ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-09 Completed Date: 2009-12-31 Revised Date: 2011-07-22 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
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Languages: eng Pagination: 1489-95 Citation Subset: AIM; IM |
Affiliation:
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Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA. afessa.bekele@mayo.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Adult Aged Aged, 80 and over Female Heart Arrest / therapy Hospital Mortality / trends* Humans Intensive Care Units / statistics & numerical data* Logistic Models Male Middle Aged Minnesota Myocardial Infarction / therapy Outcome Assessment (Health Care) / standards Patient Admission / statistics & numerical data* Patient Care / standards* Retrospective Studies Sepsis / therapy Severity of Illness Index Stroke / therapy Teaching Rounds / standards* Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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1 UL1 RR024150/RR/NCRR NIH HHS |
| Comments/Corrections | |
Comment In:
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Chest. 2009 Dec;136(6):1449-51
[PMID:
19995759
]
Chest. 2010 May;137(5):1253-4; author reply 1254 [PMID: 20442135 ] Chest. 2010 Jun;137(6):1488; author reply 1488-9 [PMID: 20525668 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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