title: Night admission is an independent risk factor for mortality in trauma patients - a systemic error approach.
abstract: OBJECTIVE
  to assess the impact of the shift inlet trauma patients, who underwent surgery, in-hospital mortality.
  
  
  METHODS
  a retrospective observational cohort study from November 2011 to March 2012, with data collected through electronic medical records. The following variables were statistically analyzed: age, gender, city of origin, marital status, admission to the risk classification (based on the Manchester Protocol), degree of contamination, time / admission round, admission day and hospital outcome.
  
  
  RESULTS
  during the study period, 563 patients injured victims underwent surgery, with a mean age of 35.5 years (± 20.7), 422 (75%) were male, with 276 (49.9%) received in the night shift and 205 (36.4%) on weekends. Patients admitted at night and on weekends had higher mortality [19 (6.9%) vs. 6 (2.2%), p=0.014, and 11 (5.4%) vs. 14 (3.9%), p=0.014, respectively]. In the multivariate analysis, independent predictors of mortality were the night admission (OR 3.15), the red risk classification (OR 4.87), and age (OR 1.17).
  
  
  CONCLUSIONS
  the admission of night shift and weekend patients was associated with more severe and presented higher mortality rate. Admission to the night shift was an independent factor of surgical mortality in trauma patients, along with the red risk classification and age.
authors.affiliation: Faculdade de Medicina da Bahia, Universidade Federal da Bahia, BA, Brazil.
authors.forename: Leonardo de Souza
authors.initials: Lde S
authors.lastname: Barbosa
authors.affiliation: Faculdade de Medicina da Bahia, Universidade Federal da Bahia, BA, Brazil.
authors.forename: Geibel Santos
authors.initials: GS
authors.lastname: dos Reis Júnior
authors.affiliation: Faculdade de Medicina da Bahia, Universidade Federal da Bahia, BA, Brazil.
authors.forename: Ricardo Zantieff Topolski
authors.initials: RZ
authors.lastname: Chaves
authors.affiliation: Faculdade de Medicina da Bahia, Universidade Federal da Bahia, BA, Brazil.
authors.forename: Davi Jorge Fontoura
authors.initials: DJ
authors.lastname: Solla
authors.affiliation: Departamento de Anestesiologia e Cirurgia, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, BA, Brazil.
authors.forename: Leonardo Fernandes
authors.initials: LF
authors.lastname: Canedo
authors.affiliation: Departamento de Anestesiologia e Cirurgia, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, BA, Brazil.
authors.forename: André Gusmão
authors.initials: AG
authors.lastname: Cunha
mesh_terms: D000328:Adult; D015982:Bias; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013997:Time Factors; D014947:Wounds and Injuries / Q000401:mortality*