Nighttime and non-business days are not associated with increased risk of in-hospital mortality in patients with severe sepsis in intensive care units in Japan: The JAAM FORECAST study

Matsumura, Yosuke; Nakada, Taka‐aki; Abe, Toshikazu; Ogura, Hiroshi; Shiraishi, Atsushi; Kushimoto, Shigeki; Saitoh, Daizoh; Fujishima, Seitaro; Mayumi, Toshihiko; Shiino, Yasukazu; Tarui, Takehiko; Hifumi, Toru; Otomo, Yasuhiro; Okamoto, Kohji; Umemura, Yutaka; Kotani, Joji; Sakamoto, Yuichiro; Sasaki, Junichi; Shiraishi, Shin‐ichiro; Takuma, Kiyotsugu; Tsuruta, Ryosuke; Hagiwara, Akiyoshi; Masuno, Tomohiko; Takeyama, Naoshi; Yamashita, Norio; Ikeda, Hiroto; Ueyama, Masashi; Fujimi, Satoshi; Gando, Satoshi

doi:10.1016/j.jcrc.2019.04.021

Cited by 10 publications

(16 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many factors can be attributed to these off-hour effects, including inadequate sta ng of specialists, reduced hospital services, decreased availability of interventions, discontinuity of care, and an overall reduction in the supervision of patients during off-hours [9,15]. Following the implementation of a multidisciplinary critical pathway based on simpli ed and standardized protocols for treating acute myocardial infarction and ischemic stroke, off-hour effects could be attenuated by improving key steps during the initial management period, such as the door-to-computed tomography-or electrocardiographytime and door-to-balloon or door-to-needle time [9,23].…”

Section: Discussionmentioning

confidence: 99%

“…They also demonstrated that the amount of time to administer antibiotics was signi cantly shorter in the nighttime than in the daytime, which may have contributed to reduced off-hour effects in sepsis treatment, and the number of patients with sepsis in the daytime was approximately double the number in the nighttime, reducing the workload of the staff [15].…”

Section: Discussionmentioning

confidence: 99%

“…This higher availability of staff at night might have led to higher rates of compliance with the sepsis bundle management [18]. Another study by Matsumura et al reported that nighttime and weekend periods were not associated with increased in-hospital mortality in severe sepsis cases [15].…”

Section: Discussionmentioning

confidence: 99%

“…Compared with daytime hours, medical services in hospitals are commonly reduced at night due to a shortage of staff, the lack of experienced clinicians, diminished access to hospital services and resources, and inadequate subspecialty care [12,14,15]. In sepsis, these off-hour characteristics may cause a critical delay in the initial management of the patient or reduced adherence to the sepsis treatment bundle [14,15]. Overall, although off-hour or nighttime admission is signi cantly associated with increased mortality risk, the associations may vary substantially among different diseases [12].…”

Section: Introductionmentioning

confidence: 99%

“…For example, many studies have demonstrated the adverse effects of off-hours admissions on diagnosis, treatment, and clinical outcomes in several diseases requiring time-sensitive interventions, such as polytrauma, myocardial infarction, and stroke [12,13]. Compared with daytime hours, medical services in hospitals are commonly reduced at night due to a shortage of staff, the lack of experienced clinicians, diminished access to hospital services and resources, and inadequate subspecialty care [12,14,15]. In sepsis, these off-hour characteristics may cause a critical delay in the initial management of the patient or reduced adherence to the sepsis treatment bundle [14,15].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Relationship Between Nighttime Emergency Department Admission and Adherence to a Sepsis Treatment Bundle

You

Park

Chung

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Nighttime hospital admission is often associated with increased mortality risk in various diseases. Following sepsis campaign implementation, this study investigated compliance rates with the Surviving Sepsis Campaign 3-h bundle for daytime and nighttime emergency department (ED) admissions and the clinical impact of compliance on mortality. Methods: We conducted an observational study using data from a prospective, multicenter registry for septic shock provided by the Korean Shock Society from 11 institutions from November 2015 to December 2017. The outcome was the compliance rate with the complete 3-hour treatment bundle according to the time of arrival in the ED. Mediation analysis was conducted to evaluate the proportion of the total effect that could be explained by hospital admission times.Results: A total of 2,247 patients were enrolled. Compared with daytime admission, nighttime admission was associated with higher compliance for the administration of antibiotics within 3-h (adjusted odds ratio (AOR), 1.276; 95% confidence interval (95% CI), 1.050–1.550, p=0.014), vasopressor within 3-h (AOR, 1.235; 95% CI, 1.009–1.512; P=0.031) and for the administration of the complete 3-h bundle (AOR, 1.231; 95% CI, 1.004–1.501; P=0.046), likely as a result of the increased volume of patients admitted during daytime hours. Consequently, daytime hospital admission adversely affected in-hospital and 28-day mortality rates, mediated by decreased compliance with the complete 3-h bundle. Conclusions: Septic shock patients admitted to the ED during the daytime exhibited lower sepsis bundle compliance than those admitted at night. Despite sepsis campaign implementation, factors that decrease bundle compliance should be reconsidered in patients with septic shock.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Relationship Between Nighttime Emergency Department Admission and Adherence to a Sepsis Treatment Bundle

You

Park

Chung

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

Day of surgery and mortality after pancreatoduodenectomy: A retrospective analysis of 29 270 surgical cases of pancreatic head cancer from Japan

Uemura

Endo

Ichihara

et al. 2021

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

Background/Purpose: The day of the week can impact medical treatment outcomes; however, few large-scale, disease-specific studies have focused on the association between the day of the week and mortality in patients after pancreatoduodenectomy for pancreatic head cancer.Methods: Data were obtained from the National Clinical Database. Twentytwo clinical variables were adopted for hierarchal logistic regression modeling to determine adjusted odds ratios (ORs) for surgical mortality after elective pancreatoduodenectomy. Results:The 30-day mortality and surgical mortality rates were 1.0% and 1.7%, respectively (n = 29 720). Surgeries were performed the least on Fridays (13.4%) compared with other weekdays. Crude rates of severe postoperative complications (mean, 14.1%; range, 13.5%-14.8%) and pancreatic fistulas (mean, 10.0%; range, 9.6%-10.3%) remained stable throughout the week. Unadjusted/adjusted ORs did not significantly differ between Friday and Monday (0.868, 95% CI: 0.636-1.173, P = .365, and 0.928, 95% CI: 0.668-1.287, P = .653, respectively), and results were similar for the remaining weekdays. Nineteen independent factors were associated with surgical mortality.

show abstract

The off-hour effect among severe trauma patients: a nationwide cohort study in Japan

et al. 2020

View full text Add to dashboard Cite

Nighttime and non-business days are not associated with increased risk of in-hospital mortality in patients with severe sepsis in intensive care units in Japan: The JAAM FORECAST study

Cited by 10 publications

References 25 publications

Relationship Between Nighttime Emergency Department Admission and Adherence to a Sepsis Treatment Bundle

Relationship Between Nighttime Emergency Department Admission and Adherence to a Sepsis Treatment Bundle

Day of surgery and mortality after pancreatoduodenectomy: A retrospective analysis of 29 270 surgical cases of pancreatic head cancer from Japan

The off-hour effect among severe trauma patients: a nationwide cohort study in Japan

Contact Info

Product

Resources

About