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J Korean Soc Emerg Med > Volume 16(4); 2005 > Article
Journal of The Korean Society of Emergency Medicine 2005;16(4): 425-432.
Clinical Study of Hospital Mortality in Patients Visiting the Emergency Room at Nighttime in a City of Korea
Jong Kuk Park, Hwa Sik Song
Department of Emergency Medicine, College of Medicine, Dankook University, Chunan, Korea. sssong@dankook.ac.kr
Attention has been focused recently on the impact of sleep deprivation, in-house staff, and overwork on patient outcome. The objective of this study was to determine whether any associations existed between the timing of a patient visit to an emergency setting and hospital mortality. METHOD: We analyzed retrospectively a series of consecutive visits to the emergency room of our hospital in 2003. Patients were divided according to the times of their visits to emergency room daytime (from 8:00 am to 6:00 pm) and nighttime (all others). We further divided nighttime visits into early nighttime (from 6:00 pm to 1:00 am) and late nighttime (from 1:00 am to 8:00 am) visits. The odds of death within 48 hours after visit for patients in the nighttime group were analyzed by using a multivariate logistic regression. The independent variable was visit to the emergency room during nighttime. RESULT: The patients visiting at night had a lower mortality (0.9% vs 1.6%, p=0.000), with an odd ratio for death within 48 hours, adjusted for severity of illness, of 1.265 (95% CI, 0.955-1.674). Severity of illness was the main contributor to the increased mortality rates of patients in the nighttime group. There was no significant difference in mortality rates between the early and the late nighttime subgroups.
Nighttime visits to the emergency room are not associated with a higher mortality than daytime visits.
Key words: Hospital mortality, Night care
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