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      내과계 중환자실 입실 시간에 따른 급성 중증 환자의 예후 = Effect of Admission Time to the Medical Intensive Care Unit on Acute Critical Patient Outcomes

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      https://www.riss.kr/link?id=A103915624

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      다국어 초록 (Multilingual Abstract)

      Background: The initial management of acute critical patients is important. However, not all hospital facilities and staff are available during off-duty time. We determined the effects of intensive care unit (ICU) admission time on patient outcomes. Methods: This retrospective cohort study was conducted in a 28-bed medical ICU in 1 tertiary university hospital. Patients who were admitted between 1 March 2009 and 31 August 2009 were divided according to the time of admission into the “duty time group” (9 AM-5 PM on weekdays) and the “off-duty time group” (5 PM? 9 AM on weekdays and at any time on weekends). The baseline characteristics and clinical outcomes were compared between these two groups. The primary endpoint of this study was hospital mortality; the secondary endpoints were ICU mortality and length of ICU stay, hospital length of stay, and mechanical ventilation time. Results: Two hundred eight (64.8%) of 321 enrolled patients were admitted during off-duty time. The baseline characteristics between the 2 groups were not significantly different. Hospital mortality was 37 (32.7%) in the “duty time group” and 82 (38.4%) in the “off-duty time group” (p=0.237). There were no significant differences in secondary endpoints between the two groups. Conclusions: Off-duty time admission to the ICU had no effect on hospital and ICU mortality, length of hospital and ICU stay, and mechanical ventilation time compared to duty time admission.
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      Background: The initial management of acute critical patients is important. However, not all hospital facilities and staff are available during off-duty time. We determined the effects of intensive care unit (ICU) admission time on patient outcomes. M...

      Background: The initial management of acute critical patients is important. However, not all hospital facilities and staff are available during off-duty time. We determined the effects of intensive care unit (ICU) admission time on patient outcomes. Methods: This retrospective cohort study was conducted in a 28-bed medical ICU in 1 tertiary university hospital. Patients who were admitted between 1 March 2009 and 31 August 2009 were divided according to the time of admission into the “duty time group” (9 AM-5 PM on weekdays) and the “off-duty time group” (5 PM? 9 AM on weekdays and at any time on weekends). The baseline characteristics and clinical outcomes were compared between these two groups. The primary endpoint of this study was hospital mortality; the secondary endpoints were ICU mortality and length of ICU stay, hospital length of stay, and mechanical ventilation time. Results: Two hundred eight (64.8%) of 321 enrolled patients were admitted during off-duty time. The baseline characteristics between the 2 groups were not significantly different. Hospital mortality was 37 (32.7%) in the “duty time group” and 82 (38.4%) in the “off-duty time group” (p=0.237). There were no significant differences in secondary endpoints between the two groups. Conclusions: Off-duty time admission to the ICU had no effect on hospital and ICU mortality, length of hospital and ICU stay, and mechanical ventilation time compared to duty time admission.

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      참고문헌 (Reference)

      1 Arabi Y, "Weekend and weeknight admissions have the same outcome of weekday admissions to an intensive care unit with onsite intensivist coverage" 34 : 605-611, 2006

      2 Ensminger SA, "The hospital mortality of patients admitted to the ICU on weekends" 126 : 1292-1298, 2004

      3 Uusaro A, "The effects of ICU admission and discharge times on mortality in Finland" 29 : 2144-2148, 2003

      4 Vincent JL, "The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine" 22 : 707-710, 1996

      5 Dellinger RP, "Surviving Sepsis Campaign guidelines formanagement of severe sepsis and septic shock" 32 : 858-873, 2004

      6 Wall R, "Protocol-driven care in the intensive care unit a tool for quality" 5 : 283-285, 2001

      7 Young MP, "Potential reduction in mortality rates using an intensivist model to manage intensive care units" 3 : 284-289, 2000

      8 Pronovost PJ, "Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review" 288 : 2151-2162, 2002

      9 Blunt MC, "Out-of-hours consultant cover and case-mix-adjusted mortality in intensive care" 356 : 735-736, 2000

      10 Meynaar IA, "Off hour admission to an intensivist-led ICU is not associated with increased mortality" 13 : R84-, 2009

      1 Arabi Y, "Weekend and weeknight admissions have the same outcome of weekday admissions to an intensive care unit with onsite intensivist coverage" 34 : 605-611, 2006

      2 Ensminger SA, "The hospital mortality of patients admitted to the ICU on weekends" 126 : 1292-1298, 2004

      3 Uusaro A, "The effects of ICU admission and discharge times on mortality in Finland" 29 : 2144-2148, 2003

      4 Vincent JL, "The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine" 22 : 707-710, 1996

      5 Dellinger RP, "Surviving Sepsis Campaign guidelines formanagement of severe sepsis and septic shock" 32 : 858-873, 2004

      6 Wall R, "Protocol-driven care in the intensive care unit a tool for quality" 5 : 283-285, 2001

      7 Young MP, "Potential reduction in mortality rates using an intensivist model to manage intensive care units" 3 : 284-289, 2000

      8 Pronovost PJ, "Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review" 288 : 2151-2162, 2002

      9 Blunt MC, "Out-of-hours consultant cover and case-mix-adjusted mortality in intensive care" 356 : 735-736, 2000

      10 Meynaar IA, "Off hour admission to an intensivist-led ICU is not associated with increased mortality" 13 : R84-, 2009

      11 Luyt CE, "Mortality among patients admitted to intensive care units during weekday day shifts compared with "off" hours" 35 : 3-11, 2007

      12 Bell CM, "Mortality among patients admitted to hospitals on weekends as compared with weekdays" 345 : 663-668, 2001

      13 Parshuram CS, "In-house, overnight physician staffing: a cross-sectional survey of Canadian adult and pediatric intensive care units" 34 : 1674-1678, 2006

      14 Morales IJ, "Hospital mortality rate and length of stay in patients admitted at night to the intensive care unit" 31 : 858-863, 2003

      15 Wunsch H, "Hospital mortality associated with day and time of admission to intensive care units" 30 : 895-901, 2004

      16 Laupland KB, "Hospital mortality among adults admitted to and discharged from intensive care on weekends and evenings" 23 : 317-324, 2008

      17 Haupt MT, "Guidelines on critical care services and personnel: recommendations based on a system of categorization of three levels of care" 31 : 2677-2683, 2003

      18 "Guidelines for the management of adults with hospital- acquired, ventilator-associated, and healthcare-associated pneumonia" 171 : 388-416, 2005

      19 MacIntyre NR, "Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians. the American Association for Respiratory Care. and the American College of Critical Care Medicine" 120 : 375S-395S, 2001

      20 Cram P, "Effects of weekend admission and hospital teaching status on in-hospital mortality" 117 : 151-157, 2004

      21 Jacobi J, "Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult" 30 : 119-141, 2002

      22 Arias Y, "Association between evening admissions and higher mortality rates in the pediatric intensive care unit" 113 : e530-534, 2004

      23 Sheu CC, "Admission time and outcomes of patients in a medical intensive care unit" 23 : 395-404, 2007

      24 Knaus WA, "APACHE II: a severity of disease classification system" 13 : 818-829, 1985

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      연월일 이력구분 이력상세 등재구분
      2025 평가예정 재인증평가 신청대상 (재인증)
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      외국어명 : The Korean Journal of Critical Care Medicine -> Acute and Critical Care
      KCI등재
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      2016-06-24 학술지명변경 한글명 : 대한중환자의학회지 -> The Korean Journal of Critical Care Medicine
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      2015-01-01 평가 등재학술지 선정 (계속평가) KCI등재
      2013-01-01 평가 등재후보 1차 PASS (등재후보1차) KCI등재후보
      2012-01-01 평가 등재후보학술지 유지 (기타) KCI등재후보
      2011-01-01 평가 등재후보 1차 FAIL (등재후보1차) KCI등재후보
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      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 0.07 0.07 0.09
      KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
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