title: Admission to hospital with community-onset bloodstream infection during the 'after hours' is not associated with an increased risk for death.
abstract: 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.
authors.affiliation: Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Alberta, Canada. Kevin.laupland@calgaryhealthregion.ca
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Laupland
mesh_terms: 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