Chest
Original ResearchCritical Care MedicineAssociation Between ICU Admission During Morning Rounds and Mortality
Section snippets
Materials and Methods
To monitor patient outcome and quality of care, four adult ICUs at our institution have used the acute physiology and chronic health evaluation (APACHE) III prognostic system since October 1994.16 This retrospective study involves the analysis of APACHE III data that were prospectively collected at the Mayo Medical Center (Rochester, MN) from October 1994 through December 2007. The study was approved by the Institutional Review Board. The Mayo Medical Center is a tertiary teaching institution
Results
Excluding 2,291 admissions for lack of research authorization, 5,992 admissions for admission to the intermediate care area, 5,944 admissions because they were repeat admissions, and 6,244 admissions because they were patients admitted to the ICU between 6:00 am and 7:59 am or 11:00 am and 12:59 pm, 49,844 of 70,315 admissions in the APACHE III database were included in the study. Of the study patients, 3,580 (7.2%) were admitted during round time. Patients in the round-time group were more
Discussion
In this study, we found ICU admission during morning rounds was associated with an increased severity-adjusted mortality rate in both postoperative and non-postoperative admissions. Patients admitted to the ICU during round time had higher severity of illness, and were more likely to be non-postoperative patients and transfers from regular wards in the same hospital. The medical ICU accounted for the highest number of deaths and round-time admissions. The association between round-time
Acknowledgments
Author contributions: Dr. Afessa contributed to the conception and design of the study, and acquisition as well as analysis and interpretation of data; drafted the submitted article and revised it; and approved the final submitted version. Dr. Gajic contributed to the conception and design of the study, and acquisition as well as analysis and interpretation of data; participated in revising the article; and approved the final submitted version. Dr. Morales contributed to the conception and
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Funding/Support: This project was supported by the Office of Faculty Development, Department of Medicine, Mayo Clinic (Rochester, MN) and by grant 1 UL1 RR024150 from the National Center for Research Resources, which is a component of the National Institutes of Health, and the National Institutes of Health Roadmap for Medical Research.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).