In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 3 ( 2023-3-16), p. e0282953-
Abstract:
Traumatic brain injury (TBI) is a time-sensitive and life-threatening medical condition. We hypothesized that off-hours, which includes night-time, weekends, and holidays, may influence mortality in TBI. Our study aimed to evaluate if the off-hours effect influences mortality in patients with TBI and whether this effect is dependent on the age group. Methods This study included patients who experienced TBI and were admitted to Chonnam National University Hospital (CNUH) between 2017 to 2020. The main exposure was arrival time at the emergency department (ED) (off-hours vs. working hours). The main outcome was mortality at hospital discharge. Multivariable logistic regression analysis was conducted to estimate the effect size of off-hours on mortality compared to that of working hours. We performed an interaction analysis between ED admission time and age group on study outcomes. Results A total of 2086 patients with TBI with intracranial injury who were transported by EMS were enrolled in our registry. In the multivariable logistic regression analysis, there was no significant difference in mortality (AOR, 95% CI (1.05 [0.54–1.81]) in patients visiting the ED during off-hours. In the interaction analysis, the effect measure of ED admission during off-hours on mortality was significant among younger people (0–17 years: 1.16 [1.03–1.31] ), compared to that in other age groups (18–64 years: 1.02 [0.48–2.39] and 65–100 years (0.99 [0.51–2.23] )). Conclusions In patients under 18 years old, admission during off-hours was associated with higher mortality at hospital discharge compared to admission during working-hours in patients with TBI with intracranial hemorrhage. EDs should be designed such that the same quality of emergency care is provided regardless of admission time.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0282953
DOI:
10.1371/journal.pone.0282953.t001
DOI:
10.1371/journal.pone.0282953.t002
DOI:
10.1371/journal.pone.0282953.t003
DOI:
10.1371/journal.pone.0282953.t004
DOI:
10.1371/journal.pone.0282953.s001
DOI:
10.1371/journal.pone.0282953.s002
DOI:
10.1371/journal.pone.0282953.r001
DOI:
10.1371/journal.pone.0282953.r002
DOI:
10.1371/journal.pone.0282953.r003
DOI:
10.1371/journal.pone.0282953.r004
DOI:
10.1371/journal.pone.0282953.r005
DOI:
10.1371/journal.pone.0282953.r006
DOI:
10.1371/journal.pone.0282953.r007
DOI:
10.1371/journal.pone.0282953.r008
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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