Acute cardiac care & resuscitation
The association of off-hour vs. on-hour intensive care unit admission time with mortality in patients with cardiogenic shock: a retrospective multi-centre analysis
Main finding · 30-day mortalityResult — go to the resultHazard ratio 1.17 CI 1.03–1.33Authors' conclusion
Our study showed an increased mortality in patients with cardiogenic shock admitted during off-hours, especially in those with a milder onset of disease.
Study context
- Population
- Patients with cardiogenic shock admitted to ICU
- Participants
- 1,720 patients
- Exposure
- Off-hour vs on-hour ICU admission
- Off-hoursn = 666
- Outcome
- Mortality
- Follow-up
- 30 days
Methodological detailsmulticentre, 2 German university hospitals
- Multicentre
- 2 German university hospitals
Main finding
30-day mortality
Hazard ratio
1.17
CI 1.03–1.33
P = 0.017
By group
Off-hours vs On-hours
HR 1.17 (CI 1.03–1.33); P = 0.017
As reported in the abstract
- Remained significant after propensity score matching
- P = 0.023
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| 30-day mortality by subgroup — Off-hours vs On-hours · without VA-ECMO | 1.17 (1.00–1.36) | P = 0.049 | |
| 30-day mortality by subgroup — Off-hours vs On-hours · without acute MI | 1.27 (1.02–1.56) | P = 0.029 | |
| 30-day mortality by subgroup — Off-hours vs On-hours · SCAI stage A and B | 2.23 (1.08–4.57) | P = 0.025 | |
| 0.20.5125Hazard ratio (log scale) |
- 30-day mortality by subgroup — No higher mortality at off-hour admission: SCAI stage D and E
- P = 0.088
- 30-day mortality by subgroup — No higher mortality at off-hour admission: SCAI stage C
- P = 0.548
- 30-day mortality by subgroup — No higher mortality at off-hour admission: requiring CPR
- P = 0.114
Original publication
The association of off-hour vs. on-hour intensive care unit admission time with mortality in patients with cardiogenic shock: a retrospective multi-centre analysis. Eur Heart J Acute Cardiovasc Care. Published 2 February 2024. doi:10.
Summarised from the published abstract; every number is checked against it