Admission to hospital with community-onset bloodstream infection during the 'after hours' is not associated with an increased risk for death.
Several studies conducted in diverse patient populations have found that patients presenting with acute illness during weekends or evening/nights are at increased risk for death. This study was conducted to examine whether patients with community-onset bloodstream infections who are admitted during evenings, nights, and weekends suffer increased mortality rates. All residents within the Calgary area who had first admissions with community-onset bloodstream infections during 2000-2008 were included. One thousand eight hundred and seventy-eight (27%) patients were admitted on a weekend. Among all admissions, 2753 (40%) were during the hours of 08:00-17:59, 1996 (29%) during 18:00-22:59, and 2174 (31%) during 23:00-07:59. More than two-thirds (n = 4867; 70%) of cases were admitted during the 'after hours' (evenings, nights, and/or weekends). The 30-day case-fatality rate was 13% (882/6923) and did not significantly vary between daytime (364/2753; 13%), evening (246/1996; 12%), and night (272/2174; 13%) admissions (p = 0.6), or with patients admitted on weekends as compared to weekdays (252/1878 (13%) vs. 630/5045 (12%); p = 0.3). Admission during the after hours (weekends and evenings/nights) was not associated with increased risk for death in logistic regression analysis (odds ratio 0.99, 95% confidence interval 0.83-1.16; p = 0.88). Admission with community-onset bloodstream infection during the after hours is not associated with adverse outcome in this region.
Laupland
Kevin B
KB
Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada. Kevin.laupland@calgaryhealthregion.ca
D000328:Adult; D039602:After-Hours Care; D000368:Aged; D016470:Bacteremia / Q000401:mortality*; D017714:Community-Acquired Infections / Q000401:mortality*; D005260:Female; D006302:Health Services Research; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D012306:Risk; D018570:Risk Assessment; D016019:Survival Analysis