Impact of intensive care unit admission during morning bedside rounds and mortality: a multi-center retrospective cohort study.

Critical Care : the Official Journal of the Critical Care Forum
Ivens Augusto O de SouzaSean M Bagshaw

Abstract

Recent data have suggested that patient admission during intensive care unit (ICU) morning bedside rounds is associated with less favorable outcome. We undertook the present study to explore the association between morning round-time ICU admissions and hospital mortality in a large Canadian health region. A multi-center retrospective cohort study was performed at five hospitals in Edmonton, Canada, between July 2002 and December 2009. Round-time ICU admission was defined as occurring between 8 and 11:59 a.m. Multivariable logistic regression analysis was used to explore the association between round-time admission and outcome. Of 18,857 unique ICU admissions, 2,055 (10.9%) occurred during round time. Round-time admissions were more frequent in community hospitals compared with tertiary hospitals (12.0% vs. 10.5%; odds ratio [OR] 1.16; 95% CI, 1.05-1.29, P < 0.004) and from the ward compared with the emergency department (ED) or operating theater (17.5% vs. 9.2%; OR 2.1; 95% CI, 1.9-2.3, P < 0.0001). Round-time admissions were more often medical than surgical (12.6% vs. 6.6%; OR 2.06; 95% CI, 1.83-2.31, P < 0.0001), had more comorbid illness (11.9% vs. 10.5%; OR 1.15; 95% CI, 1.04-1.27, P < 0.008) and higher APACHE II score (22....Continue Reading

Citations

Jul 11, 2012·Critical Care : the Official Journal of the Critical Care Forum·Jack J M LigtenbergJan C ter Maaten
Jul 25, 2017·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Michael C McCroryPeter E Morris
Apr 7, 2016·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Sandeep GangadharanPeter Silver

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