The off-hour effect among severe trauma patients: a nationwide cohort study in Japan
The off-hour effect among severe trauma patients: a nationwide cohort study in Japan
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DOI：
10.1007/s00595-020-02027-1
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发表时间：
2020-05-26
期刊：
影响因子：
2.5
通讯作者：
Oshima, Kiyohiro
中科院分区：
文献类型：
--
作者：
Aoki, Makoto;Abe, Toshikazu;Oshima, Kiyohiro
目的评估日本严重创伤患者临床结局是否存在时间差异。方法这是一项回顾性队列研究，使用日本创伤数据库的记录数据。包括损伤严重度评分大于16的严重创伤患者。到达医院的时间分为白天（上午8点-下午7时59分）晚上8点-上午7时59分）。将一周中的入院日分为工作日和非工作日。主要结局为住院死亡率。结果共分析了65,136例严重创伤患者。住院死亡率白天为15.6%，夜间为14.4%，工作日和非工作日分别为15.5%和14.6%。与白天相比，夜间与住院死亡率降低相关（比值比= 0.817，95%置信区间= 0.764-0.874），非工作日与住院死亡率无关。结论我们没有发现下班时间对严重创伤患者的住院死亡率有负面影响。
Purpose To assess whether there are temporal differences altering the clinical outcomes of severe trauma patients in Japan. Methods This was a retrospective cohort study that used recorded data from the Japan Trauma Data Bank. Severe trauma patients who had an injury severity score of greater than 16 were included. The hospital arrival time was categorized into daytime (8 a.m.-7:59 p.m.) and nighttime (8 p.m.-7:59 a.m.). The hospital arrival day of the week was categorized into business days and non-business days. The primary outcome was in-hospital mortality. Results A total of 65,136 severe trauma patients were analyzed. In-hospital mortality was 15.6% in the daytime and 14.4% in the nighttime, and 15.5%, and 14.6% on business days and non-business days, respectively. Nighttime was associated with decreased in-hospital mortality compared to daytime (odds ratio = 0.817, 95% confidence interval = 0.764-0.874) and a non-business day was not associated with in-hospital mortality. Conclusions We did not find a negative off-hour effect on in-hospital mortality among severe trauma patients.