Outcome of severe head injured patients admitted to intensive care during weekday shifts compared to nights and weekends.
BACKGROUND
Some studies have demonstrated an increased risk of death for patients admitted at nights or during weekends. This study was undertaken to investigate the demographic profile, medical interventions and outcome of severe head injury patients stratified according to day and time of admission to a specialised neurosciences intensive care unit (NICU).


METHODS
A retrospective study using a prospectively maintained severe head injury database in a tertiary hospital. Admissions to the NICU were grouped into weekdays, weeknights and weekends. A comparison of patients admitted during the day and night hours were also made.


RESULTS
A total of 838 severe head injury patients admitted to NICU were included in the study, of which 263 were admitted on weekdays, 327 on weeknights and 248 on weekends. More patients were admitted during the night (496) compared to during the day (342). There were no significant differences in the demographic profile, mechanism of injury, severity of injury, need for neurosurgical intervention, and duration of mechanical ventilation, intensive care unit (ICU) stay and mortality associated with day and time of admission. In multivariate analyses controlling for confounding factors, no statistically significant difference in ICU mortality was found with the day and time of admission.


CONCLUSIONS
There were more severe head injury patients admitted to ICU at night and on weekends, with no significant difference in demographic profile, types of injuries, need for neurosurgical interventions and duration of ICU stay and mortality in a specialised NICU with adequate staffing and requisite diagnostic and therapeutic modalities available.
Department of Neurosurgery, National Neuroscience Institute, Singapore.
Kah Keow
KK
Lee
Ivan
I
Ng
Beng Ti
BT
Ang
D000328:Adult; D000368:Aged; D006259:Craniocerebral Trauma / Q000401:mortality*; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D013997:Time Factors; D014193:Trauma Centers / Q000592:standards