title: Effects of time of hospital admission on outcomes after severe traumatic brain injury in Austria.
abstract: BACKGROUND
  The goal of this study was to compare outcomes of patients with severe traumatic brain injury (TBI) who had been admitted either during workdays from 7 a.m. to 7 p.m. ("regular service") or during any other time ("on-call service").
  
  
  METHODS
  Between March 2002 and April 2012, 17 Austrian centers enrolled TBI patients into two observational studies that focused on effects of guideline compliance (n = 400) and on prehospital and early hospital management (n = 777), respectively. Data on trauma severity, clinical status, treatment, and outcomes were collected prospectively. All patients with severe TBI (Glasgow Coma Scale score < 9) were selected for this analysis. Secondary transfers and patients with unsurvivable injuries were excluded. The International Mission for Prognosis and Analysis of Clinical Trials in TBI core model was used to estimate probabilities of hospital death and unfavorable long-term outcome (Glasgow Outcome Scale score < 4). Based on time of arrival, patients were assigned to groups "regular service" or "on-call service."
  
  
  RESULTS
  Data from 852 patients were analyzed (413 "regular," 439 "on-call service"). "On-call" patients were younger (45 vs. 51 years, P < 0.001) and had a higher rate of alcohol intoxication (41 vs. 11 %, P < 0.001). Trauma severity was comparable; the probabilities of death and unfavorable outcome were identical. There were no differences regarding computed tomography findings or treatment. Hospital mortality (24 vs. 28 %, P = 0.191) and rate of patients with unfavorable outcome at 6 months (43 vs. 48 %, P = 0.143) were comparable.
  
  
  CONCLUSIONS
  In Austria, the time of hospital admission has no influence on outcomes after severe TBI.
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Trauma Hospital "Lorenz Boehler", Donaueschingenstrasse 13, 1200, Vienna, Austria, walter.mauritz@auva.at.
authors.forename: Walter
authors.initials: W
authors.lastname: Mauritz
authors.forename: Alexandra
authors.initials: A
authors.lastname: Brazinova
authors.forename: Marek
authors.initials: M
authors.lastname: Majdan
authors.forename: Veronika
authors.initials: V
authors.lastname: Rehorcikova
authors.forename: Johannes
authors.initials: J
authors.lastname: Leitgeb
mesh_terms: D000328:Adult; D039602:After-Hours Care / Q000706:statistics & numerical data*; D001317:Austria / Q000453:epidemiology; D001930:Brain Injuries / Q000401:mortality* / Q000628:therapy*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome