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

On behalf of JAAM FORECAST Study Group

Research output: Contribution to journalArticle

Abstract

Purpose: Hospital services are reduced during off-hour such as nighttime or weekend. Investigations of the off-hour effect on initial management and outcomes in sepsis are very limited. Thus, we tested the hypothesis that patients who were diagnosed with severe sepsis during the nighttime or on non-business days had altered initial management and clinical outcomes. Materials and methods: Patients with severe sepsis from 59 ICUs between 2016 and 2017 were enrolled. The patients were categorized according to the diagnosis time or day and were then compared. The primary outcome was in-hospital mortality. Results: One thousand one hundred and forty-eight patients were analyzed; 769 daytime patients, vs. 379 nighttime patients, and 791 business day patients vs. 357 non-business day patients. There were no significant differences in in-hospital mortality between either daytime and nighttime (24.4% vs. 21.4%, P =.27; nighttime, adjusted odds ratio [OR]1.17, 95% confidence interval [CI], 0.87–1.59, P =.30)or between business and non-business days (22.9% vs. 24.6%, P =.55; non-business day, adjusted OR 0.85, 95% CI 0.60–1.22, P =.85). Time to antibiotics was significantly shorter in the nighttime (114 vs. 89 min, P =.0055). Conclusions: Nighttime and weekends were not associated with increased in-hospital mortality of severe sepsis.

Original languageEnglish
Pages (from-to)97-102
Number of pages6
JournalJournal of Critical Care
Volume52
DOIs
Publication statusPublished - 2019 Aug 1

Fingerprint

Hospital Mortality
Intensive Care Units
Sepsis
Japan
Odds Ratio
Confidence Intervals
Anti-Bacterial Agents

Keywords

  • Mortality
  • Nighttime
  • Off-hour effect
  • Sepsis
  • Severe sepsis
  • Weekend

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

@article{0082f6b2da334248adf6fe0605aefabf,
title = "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",
abstract = "Purpose: Hospital services are reduced during off-hour such as nighttime or weekend. Investigations of the off-hour effect on initial management and outcomes in sepsis are very limited. Thus, we tested the hypothesis that patients who were diagnosed with severe sepsis during the nighttime or on non-business days had altered initial management and clinical outcomes. Materials and methods: Patients with severe sepsis from 59 ICUs between 2016 and 2017 were enrolled. The patients were categorized according to the diagnosis time or day and were then compared. The primary outcome was in-hospital mortality. Results: One thousand one hundred and forty-eight patients were analyzed; 769 daytime patients, vs. 379 nighttime patients, and 791 business day patients vs. 357 non-business day patients. There were no significant differences in in-hospital mortality between either daytime and nighttime (24.4{\%} vs. 21.4{\%}, P =.27; nighttime, adjusted odds ratio [OR]1.17, 95{\%} confidence interval [CI], 0.87–1.59, P =.30)or between business and non-business days (22.9{\%} vs. 24.6{\%}, P =.55; non-business day, adjusted OR 0.85, 95{\%} CI 0.60–1.22, P =.85). Time to antibiotics was significantly shorter in the nighttime (114 vs. 89 min, P =.0055). Conclusions: Nighttime and weekends were not associated with increased in-hospital mortality of severe sepsis.",
keywords = "Mortality, Nighttime, Off-hour effect, Sepsis, Severe sepsis, Weekend",
author = "{On behalf of JAAM FORECAST Study Group} and Yosuke Matsumura and Nakada, {Taka aki} and Toshikazu Abe and Hiroshi Ogura and Atsushi Shiraishi and Shigeki Kushimoto and Daizoh Saitoh and Seitaro Fujishima and Toshihiko Mayumi and Yasukazu Shiino and Takehiko Tarui and Toru Hifumi and Yasuhiro Otomo and Kohji Okamoto and Yutaka Umemura and Joji Kotani and Yuichiro Sakamoto and Junichi Sasaki and Shiraishi, {Shin ichiro} and Kiyotsugu Takuma and Ryosuke Tsuruta and Akiyoshi Hagiwara and Kazuma Yamakawa and Tomohiko Masuno and Naoshi Takeyama and Norio Yamashita and Hiroto Ikeda and Masashi Ueyama and Satoshi Fujimi and Satoshi Gando",
year = "2019",
month = "8",
day = "1",
doi = "10.1016/j.jcrc.2019.04.021",
language = "English",
volume = "52",
pages = "97--102",
journal = "Journal of Critical Care",
issn = "0883-9441",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - 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

T2 - The JAAM FORECAST study

AU - On behalf of JAAM FORECAST Study Group

AU - Matsumura, Yosuke

AU - Nakada, Taka aki

AU - Abe, Toshikazu

AU - Ogura, Hiroshi

AU - Shiraishi, Atsushi

AU - Kushimoto, Shigeki

AU - Saitoh, Daizoh

AU - Fujishima, Seitaro

AU - Mayumi, Toshihiko

AU - Shiino, Yasukazu

AU - Tarui, Takehiko

AU - Hifumi, Toru

AU - Otomo, Yasuhiro

AU - Okamoto, Kohji

AU - Umemura, Yutaka

AU - Kotani, Joji

AU - Sakamoto, Yuichiro

AU - Sasaki, Junichi

AU - Shiraishi, Shin ichiro

AU - Takuma, Kiyotsugu

AU - Tsuruta, Ryosuke

AU - Hagiwara, Akiyoshi

AU - Yamakawa, Kazuma

AU - Masuno, Tomohiko

AU - Takeyama, Naoshi

AU - Yamashita, Norio

AU - Ikeda, Hiroto

AU - Ueyama, Masashi

AU - Fujimi, Satoshi

AU - Gando, Satoshi

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Purpose: Hospital services are reduced during off-hour such as nighttime or weekend. Investigations of the off-hour effect on initial management and outcomes in sepsis are very limited. Thus, we tested the hypothesis that patients who were diagnosed with severe sepsis during the nighttime or on non-business days had altered initial management and clinical outcomes. Materials and methods: Patients with severe sepsis from 59 ICUs between 2016 and 2017 were enrolled. The patients were categorized according to the diagnosis time or day and were then compared. The primary outcome was in-hospital mortality. Results: One thousand one hundred and forty-eight patients were analyzed; 769 daytime patients, vs. 379 nighttime patients, and 791 business day patients vs. 357 non-business day patients. There were no significant differences in in-hospital mortality between either daytime and nighttime (24.4% vs. 21.4%, P =.27; nighttime, adjusted odds ratio [OR]1.17, 95% confidence interval [CI], 0.87–1.59, P =.30)or between business and non-business days (22.9% vs. 24.6%, P =.55; non-business day, adjusted OR 0.85, 95% CI 0.60–1.22, P =.85). Time to antibiotics was significantly shorter in the nighttime (114 vs. 89 min, P =.0055). Conclusions: Nighttime and weekends were not associated with increased in-hospital mortality of severe sepsis.

AB - Purpose: Hospital services are reduced during off-hour such as nighttime or weekend. Investigations of the off-hour effect on initial management and outcomes in sepsis are very limited. Thus, we tested the hypothesis that patients who were diagnosed with severe sepsis during the nighttime or on non-business days had altered initial management and clinical outcomes. Materials and methods: Patients with severe sepsis from 59 ICUs between 2016 and 2017 were enrolled. The patients were categorized according to the diagnosis time or day and were then compared. The primary outcome was in-hospital mortality. Results: One thousand one hundred and forty-eight patients were analyzed; 769 daytime patients, vs. 379 nighttime patients, and 791 business day patients vs. 357 non-business day patients. There were no significant differences in in-hospital mortality between either daytime and nighttime (24.4% vs. 21.4%, P =.27; nighttime, adjusted odds ratio [OR]1.17, 95% confidence interval [CI], 0.87–1.59, P =.30)or between business and non-business days (22.9% vs. 24.6%, P =.55; non-business day, adjusted OR 0.85, 95% CI 0.60–1.22, P =.85). Time to antibiotics was significantly shorter in the nighttime (114 vs. 89 min, P =.0055). Conclusions: Nighttime and weekends were not associated with increased in-hospital mortality of severe sepsis.

KW - Mortality

KW - Nighttime

KW - Off-hour effect

KW - Sepsis

KW - Severe sepsis

KW - Weekend

UR - http://www.scopus.com/inward/record.url?scp=85064618273&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064618273&partnerID=8YFLogxK

U2 - 10.1016/j.jcrc.2019.04.021

DO - 10.1016/j.jcrc.2019.04.021

M3 - Article

C2 - 31035189

AN - SCOPUS:85064618273

VL - 52

SP - 97

EP - 102

JO - Journal of Critical Care

JF - Journal of Critical Care

SN - 0883-9441

ER -