Peak time for hospital deaths

Patients admitted to ICU after-hours or on weekends are more likely to die, new study finds.

Patients admitted to intensive care units (ICUs) after hours and on weekends have an increased risk of mortality, according to a study published in the Medical Journal of Australia.

The study of intensive care patients over eight years (2000-2008) from 41 hospitals all over Australia found that patients admitted after-hours had a 17 per cent hospital mortality rate compared with 14 per cent of patients admitted in hours and that patients admitted on weekends had a 20 per cent hospital mortality rate compared with 14 per cent on weekdays.

Lead researcher Dr Deepak Bhonagiri, an intensivist and conjoint lecturer in Anaesthesia Intensive Care and Emergency Medicine at Liverpool Hospital in Sydney, said that the severity of illness of the patients was higher in after-hours and weekend admissions as expected, but the increased mortality was predominantly seen in patients with planned admissions to ICU following elective surgery.

Bhonagiri said that there were several possible reasons for the increase in mortality.

“After-hours return to the ICU following elective surgery may imply prolonged surgery started in hours, where intraoperative complications have delayed ICU admission,” Bhonagiri said.

“Alternatively, these admissions may be of patients whose elective procedures were started at times when a lack of normal facilities, resources and staff have put the patient at an increased risk of death.”

Bhonagiri said that to determine whether the increased risk of mortality after-hours and on weekends is due to surgery occurring after-hours and on weekends that could have been conducted more safely during routine working hours, would require further investigation.

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